title: Hospital admission and hospital death associated to ischemic heart diseases at the National Health System (SUS).
abstract: BACKGROUND
  Analyses on mortality rate due to diseases when outcome depends on proper, timely medical intervention may point out the vulnerabilities and inequity associated to health care access. Ischemic heart diseases will act as models for such assessment.
  
  
  OBJECTIVE
  The present study investigates factors associated to the hospital death rate of patients admitted to hospital due to acute myocardial infarction (AMI) and heart failure (HF), and whether admittance through Belo Horizonte Municipal Health Office (SMSA-BH) Admission Center (AC) was in any way associated to hospital death after adjustment of relevant factors.
  
  
  METHODS
  Data obtained from the Hospital Admission Authorizations (AIH) and requests for hospital beds at SMSA data base on latest hospital admissions based on AMI or HF diagnostic hypotheses. Multivariate analysis was conducted to investigate risk factors for hospital death.
  
  
  RESULTS
  No association was found between hospital admittance access and hospital death risk from those causes. Multivariate analysis showed higher death risk for 60 and 60+ year-old patients (OR=2.9), AMI diagnostic hypothesis (OR=3.0), the need for ICU care (OR=1.6), females (OR=1.4), surgery type (OR=1.9), and public health service hospital (OR=3.5). Hospital admissions due to AMI on weekends also showed higher death risk for death (OR=1.7).
  
  
  CONCLUSIONS
  Further investigation is necessary in order to evaluate the kind of medical assistance provided on weekends at public hospitals. Other hospital factors are to be taken into account, as well as patients and assistance procedures, as subsidies for proposals to ensure higher equity and quality standard for public health services.
authors.affiliation: Municipal Secretariat of Health, Belo Horizonte / Medical School, Federal University of Minas Gerais (UFMG), Brazil. patriciaa.e@terra.com.br
authors.forename: Patrícia Alves
authors.initials: PA
authors.lastname: Evangelista
authors.forename: Sandhi Maria
authors.initials: SM
authors.lastname: Barreto
authors.forename: Henrique Leonardo
authors.initials: HL
authors.lastname: Guerra
mesh_terms: D000367:Age Factors; D000704:Analysis of Variance; D001938:Brazil / Q000453:epidemiology; D002423:Cause of Death; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000401:mortality*; D017052:Hospital Mortality; D006779:Hospitals, Public; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000401:mortality*; D009313:National Health Programs; D010343:Patient Admission; D012307:Risk Factors; D012737:Sex Factors