Difference in Patient Outcomes Coming From Public and Private Hospitals in an Intensive Care Unit in Brazil

Abstract

BACKGROUND: Compare demographic data, mortality and intensive care unit length of stay (ICU LOS) in patients coming from public hospitals of the Brazilian Unified Health System and patients coming from private hospitals of the Brazilian Supplementary Health System in a single private general ICU.METHODS: A retrospective cohort study was performed on patients in the ICU of Hospital Anchieta in Brasilia, DF, Brazil, over a period of 2 years. The patients were divided into 2 groups: patients from public hospitals of the Unified Health System group (PUBH, N = 75) and patients from private hospitals of the Brazilian Supplementary Health System group (PRIH, N = 1,614).RESULTS: In total, 1,689 patients were admitted. For the entire cohort, the median age was 62 ± 17 years, and the mean APACHE II score was 13 ± 7. The PUBH had a higher APACHE II score (18 ± 9 versus 12 ± 7, P = 0.00), were younger (53 ± 2 versus 63 ± 16 years, P = 0.00), and had higher incidence of circulatory shock (19.2 versus 11.4%, P = 0.01), and kidney injury or renal failure (38.4 versus 25.5%, P = 0.01) at the time of ICU admission, compared to the PRIH. The ICU LOS was longer for the PUBH compared to the PRIH (18 ± 18 versus 6 ± 14 days, P = 0.00). The overall mortality rate was higher for the PUBH compared to the PRIH (33.3 versus 9.7%, P = 0.00).CONCLUSIONS: In a single ICU, where patients had access to the same human and technological resources, patients from the PUBH had a higher APACHE II score, ICU LOS, and mortality rate than those from the PRIH.