Hospital mortality among psychiatric inpatients: a cross-sectional study, Brazil, 2023

To estimate the hospital mortality rate and identify factors associated with death during psychiatric hospitalizations in Brazil in 2023.

This is a cross-sectional retrospective study using data from the Brazilian Unified Health System Hospital Information System. All hospitalizations with primary diagnosis falling into codes F00-F99 of the 10th revision of the International Classification of Diseases were analyzed. The outcome was hospital death. Independent variables included sociodemographic, diagnostic and institutional characteristics. Multivariate binomial regression was used to estimate adjusted odds ratios (OR) and 95% confidence intervals (95%CI).

215,703 hospitalizations were analyzed, with 202 hospital deaths, resulting in a mortality rate of 0.9/1,000 admissions (95%CI 0.8; 1.1). Higher odds of death occurred among males (OR 1.61; 95%CI 1.17; 2.20), people aged 60+ years (OR 3.53; 95%CI 2.60; 4.80), White patients (OR 1.89; 95%CI 1.34; 2.67), in hospitalizations of up to 10 days (OR 4.16; 95%CI 3.10; 5.58) and in general hospitals (OR 1.51; 95%CI 1.12; 2.04). Lower odds were observed among patients >30 years old (OR 0.11; 95%CI 0.05; 0.24) and in hospitals under total municipal management (OR 0.74; 95%CI 0.55; 0.99).

Despite the low hospital mortality rate, the results revealed inequalities and challenges in psychiatric care. Incorporating this indicator into mental health surveillance can contribute to improving management and safety of care within the Brazilian Unified Health System.