NHS: quinta feira, o pior
Thursday is the worst day of the week to go to hospital for medical treatment, according to a new report from the Institute for Public Policy Research (ippr), published next month.
ippr's analysis highlights Healthcare Commission findings that show on average patients stay in hospital a day longer if they are admitted on a Thursday compared with being admitted on a Sunday. The research shows that the trend has remained constant for the last five years and suggests that it is the structures and procedures of the NHS, rather than medical needs, which are leading to the longer hospital stays.
ippr’s analysis suggests that around 180,000 people who were admitted on a Thursday last year were kept in hospital for an average of a day longer than the 145,000 admitted on a Sunday. This is the equivalent of an extra 500 beds used over the year as a whole.
ippr's analysis highlights Healthcare Commission findings that show on average patients stay in hospital a day longer if they are admitted on a Thursday compared with being admitted on a Sunday. The research shows that the trend has remained constant for the last five years and suggests that it is the structures and procedures of the NHS, rather than medical needs, which are leading to the longer hospital stays.
ippr’s analysis suggests that around 180,000 people who were admitted on a Thursday last year were kept in hospital for an average of a day longer than the 145,000 admitted on a Sunday. This is the equivalent of an extra 500 beds used over the year as a whole.
ippr’s report will argue that people should only be kept in hospital for the minimum time necessary for their treatment and that being in hospital for shorter periods is better for patients because:
• they are away from home and family for less time
• more patients can be treated, so others have shorter waiting times and resources can be used to improve other services
• rehabilitation at home can help patients adapt to living safely in their normal routine, rather than staying in hospital and being sent home without support
• keeping people in a hospital bed can be very expensive, both in terms of the cost of looking after them and the overheads of a hospital building
• they are less likely to contract a hospital associated infection, like MRSA.
• they are away from home and family for less time
• more patients can be treated, so others have shorter waiting times and resources can be used to improve other services
• rehabilitation at home can help patients adapt to living safely in their normal routine, rather than staying in hospital and being sent home without support
• keeping people in a hospital bed can be very expensive, both in terms of the cost of looking after them and the overheads of a hospital building
• they are less likely to contract a hospital associated infection, like MRSA.
Richard Brooks, ippr Associate Director, said:
“There is real scope for improved efficiency in our hospitals. Patients who are admitted at the end of the week are likely to be kept in hospital significantly longer than those admitted at the beginning of the week. This is not due to medical need, but because many hospitals operate a reduced service at the weekend, creating delays in treatment and discharge."
“There is real scope for improved efficiency in our hospitals. Patients who are admitted at the end of the week are likely to be kept in hospital significantly longer than those admitted at the beginning of the week. This is not due to medical need, but because many hospitals operate a reduced service at the weekend, creating delays in treatment and discharge."
Notes to Editors
The Future Hospital: the progressive case for change by Joe Farrington-Douglas with Richard Brooks will be published in January.
Statistics on the average length of stay by day of the week of admissions are from the 2006 Healthcare Commission report: Acute Hospital Portfolio: Management of admission in acute hospitals
• Sunday = 5.3 days average stay
• Monday = 5.6 days average stay
• Tuesday = 5.6 days average stay
• Wednesday = 5.8 days average stay
• Thursday = 6.3 days average stay
• Friday = 6.1 days average stay
• Saturday = 5.5 days average stay.
The report shows that this pattern has been consistent between 2001/2 and 2004/5. The figures exclude emergency trauma admissions and also long term (more than 14 days) and very short stays (less than two days). Some of the recorded stays would have been the same patients coming in repeatedly.
The Future Hospital: the progressive case for change by Joe Farrington-Douglas with Richard Brooks will be published in January.
Statistics on the average length of stay by day of the week of admissions are from the 2006 Healthcare Commission report: Acute Hospital Portfolio: Management of admission in acute hospitals
• Sunday = 5.3 days average stay
• Monday = 5.6 days average stay
• Tuesday = 5.6 days average stay
• Wednesday = 5.8 days average stay
• Thursday = 6.3 days average stay
• Friday = 6.1 days average stay
• Saturday = 5.5 days average stay.
The report shows that this pattern has been consistent between 2001/2 and 2004/5. The figures exclude emergency trauma admissions and also long term (more than 14 days) and very short stays (less than two days). Some of the recorded stays would have been the same patients coming in repeatedly.
SaudeSA: J.F., no seu hospital a demora média também aumenta às quintas feiras?
2 Comments:
Este estudo de gestão clínica/administrativa aqui apresentado e relativo ao NHS é o exemplo de muitos outros, porventura já realizados pelos informáticos da saúde ingleses e não só. Importantes sem dúvida para serem corrigidos procedimentos que conduzem a inconveniência para doentes e familiares, a aumento de morbilidade, mortalidade e de gastos com a saúde.
Desconheço se à quinta-feira, no meu Hospital ou nos HH públicos portugueses o mesmo se verifica quando analisados os dias da semana. Poderá ser o sábado ou o domingo. Poderá haver variações consoante o serviço clínico analisado ou características individuais de cada instituição.
São estudos deste género, como o projecto liderado pelo IQS de Portugal, denominado International Quality Indicator Project (IQIP), que se revelam importantes para cada instituição fazer as suas correcções. Analisa este projecto, indicadores referentes a tempo de espera e abandonos nos SU, mortalidade peri-operatória e global por GDHs, readmissões não programadas ao internamento e Bloco operatório, quedas de doentes, úlceras de pressão, imobilizações de doentes, infecções , antibioterapia e tromboprofilaxia profilática em cirurgia, etc.
Estudo referente à demora média, como aqui refere o Xavier, analisados os parâmetros que a ela possam estar associados (quadro médico/enfermagem, lotação, taxa de ocupação, MCDT disponíveis, tempos operatórios, rotinas de serviço- ao fim de semana, regionalidade, casos sociais, etc) seria um bom tema para ser abordado a nível nacional, porque não pelo IQS de Portugal.
Procurarei tentar, no meu Hospital, dar resposta a esta questão.
Obrigado pela correcção, caro Guidobaldo
Efectivamente o IQS foi extinto pelo de.lei 212/2006 e absorvido pela ACSS (Administração Central do Sistema de Saúde, IP) mas até á entrada em vigor dos diplomas orgânicos (o que ainda não sucedeu) mantem-se em funções como tal.
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