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Tag: General (Health Systems & Policy)

  • Lean care and palliative care were linked to shorter hospital stays

    What the study found

    The study found that combining palliative care and lean health care was associated with shorter hospital stays in a Brazilian public hospital. It also found that the total number of hospital deaths stayed statistically stable while deaths shifted between units.

    Why the authors say this matters

    The authors conclude that lean standardization and multiprofessional training may help optimize critical resources and reduce waste in the Brazilian Unified Health System (SUS). They also say the model expands access, reduces inequalities, and promotes dignity at the end of life, aligning with Sustainable Development Goals 3, 10, and 12.

    What the researchers tested

    The researchers used a mixed-methods design in one Brazilian public hospital. They combined qualitative documentary analysis of the Palliative Care Committee and clinical protocols with quantitative analysis of hospital indicators using statistical tests and interrupted time series analysis.

    What worked and what didn't

    Average length of stay decreased in intensive care unit/intermediate units from 7.1 to 5.5 days and in wards from 5.6 to 5.0 days. Interrupted time series analysis found an immediate reduction of 0.97 day in ward length of stay, followed by a sustained monthly decrease of 0.135 day. Despite a 26.9% increase in medical visits, total hospital deaths were statistically stable; deaths decreased in intermediate units and increased in wards.

    What to keep in mind

    The authors note that aggregated data without individual adjustment limits generalizability. They also say future multicenter studies should include outcomes focused on patient quality of life.

    • Shorter average lengths of stay were reported in ICU/intermediate units and in wards.
    • Total hospital deaths remained statistically stable even as deaths moved between units.
    • Interrupted time series analysis showed an immediate and sustained reduction in ward length of stay.
    • The study used documentary analysis plus quantitative hospital indicator analysis.
    • The authors say the findings support resource optimization and reduced waste in SUS.

  • Healthier lifestyles were linked to more TCIM use in Brazil

    What the study found

    People with healthier lifestyle profiles were more likely to report using traditional, complementary and integrative medicine (TCIM), such as acupuncture, homeopathy, medicinal plants, and phytotherapy. The study also found that all three lifestyle profiles had a high prevalence of sedentary behavior.

    Why the authors say this matters

    The authors suggest that TCIM use may reflect broader health-oriented behavior patterns. They conclude that this supports considering these approaches in public health planning.

    What the researchers tested

    The researchers did a secondary analysis of data from the 2019 Brazilian National Health Survey. They grouped physical activity, sedentary behavior, and diet into lifestyle profiles using two-step cluster analysis, and they assessed TCIM use by self-report. They then used logistic regression to examine the association between lifestyle profiles and TCIM adoption.

    What worked and what didn't

    Three lifestyle profiles were identified among 90,814 people aged over 15 years. Compared with the least healthy profile, people in healthier lifestyle profiles were significantly more likely to report TCIM use, with an adjusted odds ratio of 1.55 (95% CI 1.34–1.81). The abstract says all profiles showed high sedentary behavior, and it notes that the at-risk group made up about 25% of the sample and had poor diet, low physical activity, and high screen time.

    What to keep in mind

    This was an observational secondary analysis, so the abstract does not describe causal effects. TCIM use was self-reported, and the summary does not provide additional limitations beyond the sample being from Brazil's 2019 national survey.

    • Healthier lifestyle profiles were associated with higher TCIM adoption.
    • All three lifestyle profiles showed high sedentary behavior.
    • TCIM examples in the study included acupuncture, homeopathy, medicinal plants, and phytotherapy.
    • The analysis included 90,814 people aged over 15 years from the 2019 Brazilian National Health Survey.
    • The at-risk group was about 25% of the sample and had poor diet, low physical activity, and high screen time.