Mortality due to COVID-19 in public and private hospitals in Florianópolis / SC

Abstract

Introduction: The access to COVID-19 hospital treatment is important to mitigate the impact caused by socioeconomic issues in the treatment of the disease. Objective: To analyze the difference between public and private hospital care in mortality due to COVID-19 in Florianópolis/SC, Brazil. Methods: Historical cohort with confirmed patient data with notification made between February 22^nd 2020 and November 9^th 2020 in hospitals in the city. Data were provided by the Municipal Health Secretariat. In order to control the socioeconomic factors that could simultaneously influence the search for the type of hospital and mortality, a double-robustness approach was used. In the first stage, pairing of notified individuals in public and private hospitals was carried out by genetic algorithm, using sample replacement. In the second stage, the probability of death was estimated, conditioned by the type of hospital (public or private), symptoms, comorbidities, socioeconomic factors, age, age squared, sex, race / skin color and month of symptom onset using a logistic regression. Finally, the difference between the densities of probability of death of the two hospital types was analyzed. Results: Data from 2,497 people, 1,244 from public hospitals and 1,253 from private hospitals were analyzed. The conditional probability of death assuming that all patients were notified in public hospitals was 0.0010 (95% CI 0.0001; 0.0046) and if all were notified in private hospitals it was 0.0009 (95% CI 0.0001; 0.0039). The difference between the two probabilities was -0,0002 (95% CI -0.0013; 0.0005). Conclusion: The probability of death from COVID-19 was similar among patients seen in public and private hospitals during the period studied.