High discrepancies in the mortality of hospitalized patients with COVID-19 in the two most economically important states in Brazil

Detalhes bibliográficos
Autor(a) principal: Paravidino, Vitor Barreto
Data de Publicação: 2021
Outros Autores: Sichieri, Rosely, Gomes, Danilo Cosme Klein, Silva, Gulnar Azevedo e
Tipo de documento: preprint
Idioma: eng
Título da fonte: SciELO Preprints
Texto Completo: https://preprints.scielo.org/index.php/scielo/preprint/view/2989
Resumo: Objective: To compare the proportion of deaths among hospitalized cases of COVID-19 in São Paulo and Rio de Janeiro, stratified by private and public services. Methods: Hospitalization data for Severe Acute Respiratory Syndrome (SARS) was obtained by the SIVEP-Gripe Database. All hospitalized adults who were diagnosed as COVID-19 or unspecified SARS, between January and December 2020, were included in the analysis. Logistic regression models were fitted to evaluate the risk of death between Rio de Janeiro and São Paulo, adjusted for age, sex, and comorbidities. Results: A total of 388,657 hospital registers for Rio de Janeiro and São Paulo (91,532 and 297,125, respectively) were analyzed. Missing data is frequent in the database and it was greater in Rio de Janeiro, at the state and capital levels. Adjusting for confounders, the odds ratio of dying by Covid-19, comparing the state of Rio de Janeiro with São Paulo, was 2.51 in the private hospitals and 2.29 in the public ones. For the capitals, the scenario is worse. The lethality among hospitalized patients with COVID-19 in Rio de Janeiro is at least twice compared to São Paulo, both at the states and capitals. The public or private services showed important differences, with odds ratios of 2.74 and 3.46, respectively. Conclusion: It appears that the worst governance in the health sector in Rio the Janeiro, more than lack of resources, explains the excess mortality of hospitalized Covid-19 patients in Rio de Janeiro.
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spelling High discrepancies in the mortality of hospitalized patients with COVID-19 in the two most economically important states in BrazilAlta discrepância na mortalidade de pacientes hospitalizados por COVID-19 nos dois estados mais importantes economicamente do BrasilCovid-19Mortalidade hospitalarAtenção à saúdeBrasilCovid-19Hospital mortalityDelivery of Health CareBrazilObjective: To compare the proportion of deaths among hospitalized cases of COVID-19 in São Paulo and Rio de Janeiro, stratified by private and public services. Methods: Hospitalization data for Severe Acute Respiratory Syndrome (SARS) was obtained by the SIVEP-Gripe Database. All hospitalized adults who were diagnosed as COVID-19 or unspecified SARS, between January and December 2020, were included in the analysis. Logistic regression models were fitted to evaluate the risk of death between Rio de Janeiro and São Paulo, adjusted for age, sex, and comorbidities. Results: A total of 388,657 hospital registers for Rio de Janeiro and São Paulo (91,532 and 297,125, respectively) were analyzed. Missing data is frequent in the database and it was greater in Rio de Janeiro, at the state and capital levels. Adjusting for confounders, the odds ratio of dying by Covid-19, comparing the state of Rio de Janeiro with São Paulo, was 2.51 in the private hospitals and 2.29 in the public ones. For the capitals, the scenario is worse. The lethality among hospitalized patients with COVID-19 in Rio de Janeiro is at least twice compared to São Paulo, both at the states and capitals. The public or private services showed important differences, with odds ratios of 2.74 and 3.46, respectively. Conclusion: It appears that the worst governance in the health sector in Rio the Janeiro, more than lack of resources, explains the excess mortality of hospitalized Covid-19 patients in Rio de Janeiro.Objetivo: Comparar a proporção de óbitos entre os casos de COVID-19 hospitalizados em São Paulo e Rio de Janeiro, estratificados por serviços públicos e privados. Métodos: Os dados de hospitalização por Síndrome Respiratória Aguda Grave (SRAG) foram obtidos pelo banco de dados SIVEP-Gripe. Todos os adultos hospitalizados com diagnóstico de COVID-19 ou SRAG não-especificado, entre janeiro e dezembro de 2020, foram incluídos na análise. Modelos de regressão logística foram usados para avaliar o risco de morte entre Rio de Janeiro e São Paulo, ajustados para idade, sexo e comorbidades. Resultados: Foram analisados ​​388.657 registros hospitalares do Rio de Janeiro e São Paulo (91.532 e 297.125, respectivamente). Os dados faltantes no banco são frequentes e maior no Rio de Janeiro (estado e capital). Ajustando para fatores de confusão, a razão de chance de morrer por Covid-19, comparando o estado do Rio de Janeiro com São Paulo, foi de 2,51 nos hospitais privados e 2,29 nos públicos. Para as capitais, o cenário é pior. A letalidade entre pacientes internados com COVID-19 no Rio de Janeiro é pelo menos o dobro em relação a São Paulo, tanto para os estados quanto para as capitais. Os serviços públicos ou privados apresentaram diferenças importantes, com razão de chance de 2,74 e 3,46, respetivamente. Conclusão: Parece que a pior governança do setor da saúde no Rio de Janeiro, mais do que falta de recursos, explica o excesso de mortalidade de pacientes internados com Covid-19 no Rio de Janeiro.  SciELO PreprintsSciELO PreprintsSciELO Preprints2021-09-24info:eu-repo/semantics/preprintinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://preprints.scielo.org/index.php/scielo/preprint/view/298910.1590/1980-549720210056enghttps://preprints.scielo.org/index.php/scielo/article/view/2989/5323Copyright (c) 2021 Vitor Barreto Paravidino, Rosely Sichieri, Danilo Cosme Klein Gomes, Gulnar Azevedo e Silvahttps://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessParavidino, Vitor BarretoSichieri, RoselyGomes, Danilo Cosme KleinSilva, Gulnar Azevedo ereponame:SciELO Preprintsinstname:SciELOinstacron:SCI2021-09-24T14:08:54Zoai:ops.preprints.scielo.org:preprint/2989Servidor de preprintshttps://preprints.scielo.org/index.php/scieloONGhttps://preprints.scielo.org/index.php/scielo/oaiscielo.submission@scielo.orgopendoar:2021-09-24T14:08:54SciELO Preprints - SciELOfalse
dc.title.none.fl_str_mv High discrepancies in the mortality of hospitalized patients with COVID-19 in the two most economically important states in Brazil
Alta discrepância na mortalidade de pacientes hospitalizados por COVID-19 nos dois estados mais importantes economicamente do Brasil
title High discrepancies in the mortality of hospitalized patients with COVID-19 in the two most economically important states in Brazil
spellingShingle High discrepancies in the mortality of hospitalized patients with COVID-19 in the two most economically important states in Brazil
Paravidino, Vitor Barreto
Covid-19
Mortalidade hospitalar
Atenção à saúde
Brasil
Covid-19
Hospital mortality
Delivery of Health Care
Brazil
title_short High discrepancies in the mortality of hospitalized patients with COVID-19 in the two most economically important states in Brazil
title_full High discrepancies in the mortality of hospitalized patients with COVID-19 in the two most economically important states in Brazil
title_fullStr High discrepancies in the mortality of hospitalized patients with COVID-19 in the two most economically important states in Brazil
title_full_unstemmed High discrepancies in the mortality of hospitalized patients with COVID-19 in the two most economically important states in Brazil
title_sort High discrepancies in the mortality of hospitalized patients with COVID-19 in the two most economically important states in Brazil
author Paravidino, Vitor Barreto
author_facet Paravidino, Vitor Barreto
Sichieri, Rosely
Gomes, Danilo Cosme Klein
Silva, Gulnar Azevedo e
author_role author
author2 Sichieri, Rosely
Gomes, Danilo Cosme Klein
Silva, Gulnar Azevedo e
author2_role author
author
author
dc.contributor.author.fl_str_mv Paravidino, Vitor Barreto
Sichieri, Rosely
Gomes, Danilo Cosme Klein
Silva, Gulnar Azevedo e
dc.subject.por.fl_str_mv Covid-19
Mortalidade hospitalar
Atenção à saúde
Brasil
Covid-19
Hospital mortality
Delivery of Health Care
Brazil
topic Covid-19
Mortalidade hospitalar
Atenção à saúde
Brasil
Covid-19
Hospital mortality
Delivery of Health Care
Brazil
description Objective: To compare the proportion of deaths among hospitalized cases of COVID-19 in São Paulo and Rio de Janeiro, stratified by private and public services. Methods: Hospitalization data for Severe Acute Respiratory Syndrome (SARS) was obtained by the SIVEP-Gripe Database. All hospitalized adults who were diagnosed as COVID-19 or unspecified SARS, between January and December 2020, were included in the analysis. Logistic regression models were fitted to evaluate the risk of death between Rio de Janeiro and São Paulo, adjusted for age, sex, and comorbidities. Results: A total of 388,657 hospital registers for Rio de Janeiro and São Paulo (91,532 and 297,125, respectively) were analyzed. Missing data is frequent in the database and it was greater in Rio de Janeiro, at the state and capital levels. Adjusting for confounders, the odds ratio of dying by Covid-19, comparing the state of Rio de Janeiro with São Paulo, was 2.51 in the private hospitals and 2.29 in the public ones. For the capitals, the scenario is worse. The lethality among hospitalized patients with COVID-19 in Rio de Janeiro is at least twice compared to São Paulo, both at the states and capitals. The public or private services showed important differences, with odds ratios of 2.74 and 3.46, respectively. Conclusion: It appears that the worst governance in the health sector in Rio the Janeiro, more than lack of resources, explains the excess mortality of hospitalized Covid-19 patients in Rio de Janeiro.
publishDate 2021
dc.date.none.fl_str_mv 2021-09-24
dc.type.driver.fl_str_mv info:eu-repo/semantics/preprint
info:eu-repo/semantics/publishedVersion
format preprint
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dc.identifier.uri.fl_str_mv https://preprints.scielo.org/index.php/scielo/preprint/view/2989
10.1590/1980-549720210056
url https://preprints.scielo.org/index.php/scielo/preprint/view/2989
identifier_str_mv 10.1590/1980-549720210056
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://preprints.scielo.org/index.php/scielo/article/view/2989/5323
dc.rights.driver.fl_str_mv https://creativecommons.org/licenses/by/4.0
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dc.publisher.none.fl_str_mv SciELO Preprints
SciELO Preprints
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SciELO Preprints
SciELO Preprints
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