Public versus Private Healthcare Systems following Discharge from the ICU: A Propensity Score-Matched Comparison of Outcomes.
Purpose. The long-term outcomes of patients after discharge from tertiary ICUs as they relate to the public versus private healthcare systems in Brazil have not yet been evaluated. Materials and Methods. A multicenter prospective cohort study was conducted to compare the all-cause mortality and the physical functional status (PFS) 24 months after discharge from the ICU between adult patients treated in the public and private healthcare systems. A propensity score- (PS-) matched comparison of all causes of mortality and PFS 24 months after discharge from the ICU was performed. Results. In total, 928 patients were discharged from the ICU including 172 (18.6%) patients in the public and 756 (81.4%) patients in the private healthcare system. The results of the PS-matched comparison of all-cause mortality revealed higher mortality rates among the patients of the public healthcare system compared to those of the private healthcare system (47.3% versus 27.6%, P = 0.003). The comparison of the PS-matched Karnofsky performance and Lawton activities of daily living scores between the ICU survivors of the public and private healthcare systems revealed no significant differences. Conclusions. The patients of private healthcare system exhibited significantly greater survival rates than the patients of the public healthcare system with similar PFS following ICU discharge.
Department of Critical Care, Hospital Moinhos de Vento, Ramiro Barcelos 910/605, 90035-001 Porto Alegre, RS, Brazil.
Felippe Leopoldo
FL
Dexheimer Neto
Department of Critical Care, Hospital Moinhos de Vento, Ramiro Barcelos 910/605, 90035-001 Porto Alegre, RS, Brazil.
Regis Goulart
RG
Rosa
Department of Critical Care, Hospital Moinhos de Vento, Ramiro Barcelos 910/605, 90035-001 Porto Alegre, RS, Brazil.
Bruno Achutti
BA
Duso
Jaqueline Sangiogo
JS
Haas
Department of Critical Care, Hospital Moinhos de Vento, Ramiro Barcelos 910/605, 90035-001 Porto Alegre, RS, Brazil.
Augusto
A
Savi
Department of Critical Care, Hospital Moinhos de Vento, Ramiro Barcelos 910/605, 90035-001 Porto Alegre, RS, Brazil.
Cláudia da Rocha
Cda R
Cabral
Department of Critical Care, Hospital Moinhos de Vento, Ramiro Barcelos 910/605, 90035-001 Porto Alegre, RS, Brazil.
Juçara Gasparetto
JG
Maccari
Department of Critical Care, Hospital Moinhos de Vento, Ramiro Barcelos 910/605, 90035-001 Porto Alegre, RS, Brazil.
Roselaine Pinheiro
RP
de Oliveira
Department of Critical Care, Hospital Moinhos de Vento, Ramiro Barcelos 910/605, 90035-001 Porto Alegre, RS, Brazil.
Ana Carolina Peçanha
AC
Antônio
Department of Critical Care, Hospital Moinhos de Vento, Ramiro Barcelos 910/605, 90035-001 Porto Alegre, RS, Brazil.
Priscylla de Souza
Pde S
Castro
Department of Critical Care, Hospital Moinhos de Vento, Ramiro Barcelos 910/605, 90035-001 Porto Alegre, RS, Brazil.
Cassiano
C
Teixeira
D000328:Adult; D000368:Aged; D001938:Brazil; D003695:Delivery of Health Care; D005260:Female; D016304:Hospitals, Private; D006779:Hospitals, Public; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009026:Mortality; D015996:Survival Rate