Understanding the large heterogeneity in hospital readmissions and mortality for acute myocardial infarction

• Tipo: Artigo em Revista Científica Internacional
• Data: 2020

Autores

Lobo, MF (Autor) FMUP; Azzone, V (Autor) Outra; Lopes, F (Autor) Outra; Freitas A (Autor) FMUP; Costa-Pereira A (Autor) FMUP; Normand, SL (Autor) Outra; Teixeira Pinto, A (Autor) Outra

Revista

Título: Health Policy

Vol. 124

Páginas: 684-694

ISSN: 0168-8510

Editora: Elsevier

Indexação

ISI Web of Knowledge - 1 Citação

Scopus - 1 Citação

Outras Informações

ID Authenticus: P-00S-8W1

DOI: 10.1016/j.healthpol.2020.04.004

Abstract (EN): This study aims to investigate the variation in two acute myocardial infarction (AMI) outcomes across public hospitals in Portugal. In-hospital mortality and 30-day unplanned readmissions were studied using two distinct AMI cohorts of adults discharged from all acute care public hospital centers in Portugal from 2012-2015. Hierarchical generalized linear models were used to assess the association between patient and hospital characteristics and hospital variability in the two outcomes. Our findings indicate that hospitals are not performing homogeneously-the risk of adverse events tends to be consistently larger in some hospitals and consistently lower in other hospitals. While patient characteristics accounted for a larger share of the explained between-hospital variance, hospital characteristics explain an additional 8% and 10% of hospital heterogeneity in the mortality and the readmission cohorts respectively. Admissions to hospitals with low AMI caseloads or located in Alentejo/Algarve and Lisbon had a higher risk of mortality. Discharges from larger-sized hospitals were associated with increased risk of readmissions. Future health policies should incorporate these findings in order to incentivize more consistent health care outcomes across hospitals. Further investigation addressing geographical disparities, hospital caseload and practices is needed to direct actions of improvement to specific hospitals. (C) 2020 Published by Elsevier B.V.

Idioma: Inglês

Tipo (Avaliação Docente): Científica

Nº de páginas: 11