Are changes in vital signs, mobility, and mental status while in hospital measures of the quality of care?

INTRODUCTION: Little is known of the changes in patients' health condition while in hospital in low-resource settings. The aim of this exploratory study is to examine dependency of patients on hospital admission and discharge in a low-resource sub-Saharan hospital.

METHODS: We carried out a retrospective observational study of changes in the health condition, as reflected by their mental status, mobility and vital signs, of 5,888 consecutive patients between hospital admission and discharge.

RESULTS: Mental status, mobility and vital signs were normal in 25% of patients on hospital admission and 30% of patients at discharge. Although very few patients with normal mental status, mobility and vital signs on admission died in hospital, the condition of 40% of them deteriorated.

CONCLUSION: No comparative data on changes in health condition between hospital admission and discharge have been published. Our proposed health condition categories identify changes that may matter most to patients and should be considered as a standard metric of hospital care.