Are heart attacks deadlier on weekends? Evidence of weekend effect in Brazil/Os ataques cardiacos sao mais letais nos fins de semana? Evidencia do "efeito final de semana" no Brasil

• Published in: Ciência & saude coletiva 2024-08, Vol.29 (8), p.1
• Main Authors: Soares Leivas, Pedro Henrique, Madeira Triaca, Livia, Moreira Aristides dos Santos, Anderson, Andrade Jacinto, Paulo de, Oviedo Tejada, Cesar Augusto
• Format: Article
• Language: Portuguese
• ISSN: 1413-8123
• DOI: 10.1590/1413-81232024298.03892023

This article aims to examine the effects of weekend admission on in-hospital mortality for patients with acute myocardial infarction (AMI) in Brazil. Information from the Hospital Information System of the Unified Health System (SIH/SUS) of urgently admitted patients diagnosed with acute myocardial infarction (AMI) between 2008 and 2018 was used, made available through the Hospital Admission Authorization (AIH). Multivariable logistic regression models, controlling for observable patient characteristics, hospital characteristics and year and hospital-fixed effects, were used. The results were consistent with the existence of the weekend effect. For the model adjusted with the inclusion of all controls, the chance of death observed for individuals hospitalized on the weekend is 14% higher. Our results indicated that there is probably an important variation in the quality of hospital care depending on the day the patient is hospitalized. Weekend admissions were associated with in-hospital AMI mortality in Brazil. Future research should analyze the possible channels behind the weekend effect to support public policies that can effectively make healthcare equitable. Key words Acute myocardial infarction, In-hospital mortality, Brazil O objetivo deste artigo e examinar os efeitos da internacao no final de semana na mortalidade hospitalar de pacientes com infarto agudo do miocardio (IAM) no Brasil. Foram utilizadas informacoes do Sistema de Informacao Hospitalar do Sistema Unico de Saude (SIH/SUS) de pacientes internados em urgencia com diagnostico de infarto agudo do miocardio (IAM) entre 2008 e 2018, disponibilizados por meio da Autorizacao de Internacao Hospitalar (AIH). Foram usados modelos de regressao logistica multivariada, controlando as caracteristicas observaveis do paciente, caracteristicas do hospital e efeitos fixos de ano e hospital. Os resultados foram consistentes com a existencia do efeito fim de semana. Para o modelo ajustado com a inclusao de todos os controles, a chance de obito observada para individuos internados no final de semana e 14% maior. Nossos resultados indicaram que provavelmente existe uma variacao importante na qualidade da assistencia hospitalar dependendo do dia em que o paciente fica internado. Internacoes em finais de semana foram associadas a mortalidade por IAM intra-hospitalar no Brasil. Pesquisas futuras devem analisar os possiveis canais por tras do weekend effect para subsidiar politicas publicas que possam efetivament