The study,spearheaded by researcher Mariana Lobo and carried out at the Research Centre for Health Technologies and Services (Cintesis), was based on more than 38,000 inpatient records from 37 hospital centres on mainland Portugal between 2012 and 2015.
Among the findings in the study, was that heart attack sufferers are 30 percent more likely to die if they are admitted to public hospitals in Lisbon, the Alentejo and the Algarve, than in northern Portugal.
This, Ms. Lobo said, suggests that the care administered to heart attack patients is not equal throughout the country and, researchers say, the discrepancies, which in some cases are significant, should be investigated.
“Mortality should be homogenous, but it’s not”, she added, even after risk factors such as associated pathologies are ruled out.
Another finding established through the study was that – as expected – the care provided was better with the more cases treated, but another more unexpected finding emerged, that the smaller the hospital, the better the results.
These findings are not surprising,” comments Luís Azevedo, who also integrates Cintesis’s Cute Heart (Comparative Use of Technologies for Coronary Heart Disease) project, adding: “The variability in hospital outcomes is a known phenomenon” and studied internationally.
But, he reflects, this work is very important to draw the attention of researchers and policy-makers in Portugal.
“This material requires reflection, and we must now try to understand what lies at the root of these differences.
Moreover, it is not surprising to conclude that it is the hospitals with more experience and more cases that have better results”.
As for the size of the hospitals, he adds, it is clearly not the largest and ones with the most beds that have the best results, which may mean that when they are overloaded, there are an increases in waiting times.
It is therefore necessary to invest in a “best referral network with very experienced professionals and adequate technological support, not necessarily concentrating care in large centres”, he argues.