2020年至2022年巴西COVID-19住院患者死亡率:基于二次数据的横截面综述研究
Margareth Crisóstomo Portela1, Mônica Martins2, Sheyla Maria Lemos Lima2
1Department of Health Administration and Planning, Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil. margareth.portela@fiocruz.br.
International journal for equity in health
|November 18, 2023
概括
COVID-19凸显了巴西的医疗保健差异,公共统一卫生系统 (SUS) 服务于弱势群体,并经历了较高的住院患者死亡率. 扭转SUS投资不足对于减少国家不平等至关重要.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 巴西的统一卫生系统 (SUS) 面临着先前存在的挑战,包括资金不足和资源分配不平等.
- COVID-19大流行加剧了巴西现有的社会经济和医疗保健准入不平等.
- 这项研究检查了公共,私人营利性和私人非营利性医疗机构的COVID-19住院患者死亡率.
研究的目的:
- 提供巴西COVID-19住院患者死亡率的概述.
- 探索影响COVID-19住院患者死亡率变化的因素.
- 为了比较服务于SUS的设施和主要服务于私人保险持有人的设施之间的结果.
主要方法:
- 使用SIVEP-Gripe (严重急性呼吸道疾病记录) 的公开二次数据进行横截面研究.
- 综合数据来自国家卫生机构记录,SUS医院住院信息系统和IBGE.
- 分析了使用通用线性混合模型在≥100例病例的单位的成年COVID-19住院病例 (2020年2月至2022年12月).
主要成果:
- SUS覆盖了大约70%的COVID-19住院治疗,为弱势群体提供服务,并表现出更糟糕的住院死亡率.
- 私立和慈善医院,通常为更高的社会经济阶层提供服务,通常显示出更好的结果.
- 在黑人和土著人群中观察到更高的住院患者死亡率,低人类发展指数 (HDI) 市政当局的居民,以及远离家园住院的人. 接种疫苗后 (2021年7月以后) 的死亡率显著下降.
结论:
- COVID-19凸显了巴西社会经济和医疗保健方面的巨大不平等.
- 疫情揭示了苏联的关键重要性和脆弱性.
- 增加对公共卫生保健系统的投资对于减轻巴西的健康不平等至关重要.
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