医院类型 (公共与私人) 对中风后死亡率和存活率的影响
Carla Heloisa Cabral Moro1, Maria Izabel Rodrigues Mendes2, Milena Veiga Wiggers2
1Hospital Municipal São José, Departamento de Neurologia, Joinville SC, Brazil.
Arquivos de neuro-psiquiatria
|June 20, 2025
概括
脑卒中单位是重要的公共卫生政策,最大限度地减少脑卒中的影响. 这项研究发现,公立和私立医院之间的死亡率没有显著差异,强调了专门的中风护理单位的重要性.
科学领域:
- 神经学 神经学
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在巴西,中风仍然是导致死亡的主要原因.
- 在一些巴西城市,紧急/紧急中风护理单位已经实施.
- 对中风患者的公立医院护理与私人医院护理的比较影响,特别是关于中风病房的比较影响,仍然没有得到评估.
研究的目的:
- 为了比较中风患者的死亡率和存活率,这些患者被录入公共医院,有中风病房,与没有中风病房的私立医院相比.
- 评估医院类型和中风病房存在对患者结果的影响.
主要方法:
- 从2018年1月到2020年12月,在巴西南部的Joinville进行了一项历史队列研究.
- 来自一家公共医院的中风患者与两家私立医院没有中风病房的患者进行了比较.
- 考克斯回归分析用于比较死亡率和30天生存率.
主要成果:
- 该研究包括4,508名中风患者;85.6%在公立医院接受治疗,14.4%在私立医院接受治疗.
- 公立医院的原始死亡率为11.4%,私立医院为9.1% (p=0.085).
- 多变量分析显示,在公共医院有中风病房和私立医院没有中风病房之间,死亡率没有统计学上显著的差异 (危险比率=1.21;95% CI:0.87-1.68;p=0.262).
结论:
- 尽管在这个特定群体中没有统计学上显著的差异,但中风单位被强调为关键的公共政策干预.
- 这些发现强调了专门的中风护理单位在减轻中风影响方面的重要性,无论医院的所有权如何.
- 可能需要进一步的研究,以充分阐明医院类型和中风病房可用性对中风结果的细微影响.
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