Relationship between Expenses on Nutritional Therapy and Mortality Rate in Public Hospitals in Salvador, Bahia: An Ecological Study

Abstract

AbstractNutritional therapy (NT) is a set of procedures that maintain or recover the nutritional status. In hospitals, there is a prevalence of 15% to 60% of cases of malnourishment. Malnutrition is related to an increase in infections, immune system dysfunction, longer hospital length of stay and higher mortality. Therefore, a multidisciplinary nutrition therapy team (MNTT) is indispensable. There are gaps regarding the impact of these procedures. The present study aims to analyze the relationship between the expenses on NT and the mortality rate in public hospitals in the city of Salvador, Bahia, Brazil. The present is an ecological study, and data were collected from the Computer Sciences Department of the Brazilian Unified Health System (DATASUS, in Portuguese), regarding the expenses on enteral nutritional therapy (ENT) and parenteral nutritional therapy (PNT) and the mortality rate in public hospitals, from January 2008 to December 2018. The analyses were developed to enable the determination of the exposure associated with the health indicator studied through the adjustment of the curves. The expenses on NT correlated with the mortality rate were represented as a geometric regression curve, revealing a negative β coefficient (-0.3648), showing an inversely proportional relationship (p = 0.0096). For the expenses on ENT, a geometric regression was evidenced, revealing a negative β coefficient (-1.8790), demonstrating an inversely proportional relationship (p = 0.0034). The expenses on PNT evidenced a logarithmic regression, revealing a negative β coefficient (-9824,7295), but with no statistical significance (p = 0.4767). Hospitals that do not provide NT have shown a growth tendency regarding the mortality rate. We concluded that the implementation of a MNTT in public hospitals seems to reduce the mortality rate in the hospital.