Pain as the fifth vital sign: a comparison between public and private healthcare systems

Abstract

Background The assessment of pain as the fifth vital sign (P5VS) is of paramount importance since it leads to the management of undertreated pain, consequently reducing suffering, readmissions and emergency department visits after hospital discharge. Objective To evaluate the implementation of P5VS in public and private hospitals. Methods Data analysis on validated questionnaires was sent to all 171 Portuguese hospitals via an official letter. Results When compared to private hospitals, public hospitals presented a higher adherence to the process related to the P5VS. It has demonstrated superiority in the charts properly placed to record P5VS, in the number of emergency departments recording P5VS, in the regularity of audits, and in the existence of guidelines and staff training on pain assessment and management. Conclusion The standardization of both evaluation and recording of pain intensity constitutes a measure of good clinical practice. Public hospitals demonstrated better commitment to these procedures that should be properly carried out in all health care institutions.