ICUs in public hospitals are less efficient – 04/18/2023 – Health

Intensive care units (ICUs) in public hospitals in Brazil are much less efficient and have lower performance than those managed by the private hospital network.

An unprecedented survey among 707 hospitals with intensive care units (representing half of those in the country) reveals that only 18 under public management have a rate considered to be high performance. Among private hospitals, 117 are on the list.

In the universe of the 707 researched hospitals that have ICUs, 40% are public; and 60% private. Even so, the discrepancy in the performance of public and private units is much greater than sample bias could produce.

The survey was carried out by Amib (Associação de Medicina Intensiva Brasileira) in partnership with Epimed Solutions, a company founded by intensive care physicians specializing in solutions to increase efficiency in hospital management.

There are basically two criteria adopted to evaluate the ICUs, the results of which will be published annually by Amib: 1) mortality rate in the units adjusted by the severity of the hospitalization; and 2) resource utilization rate during the patient’s hospital stay.

The research is part of the Brazilian UTIs project, created in 2010, with the aim of characterizing the epidemiological profile of intensive care units in the country and sharing information that may be useful to guide health policies and strategies, with the aim of improving care. of critical patients.

During the worst months of the pandemic, in 2020 and 2021, Amib data were essential for states and municipalities to have a map of available ICUs in various regions of Brazil.

According to intensive care physician Ederlon Rezende, a member of Amib, the list of hospitals with ICUs awarded the “Top Performer” seal is not a ranking, since those that performed in the best tertile group receive the distinction (the ICUs are divided into three tertiles: best, average and worst performance).

In total, 135 (19.1%) of the 707 hospitals with intensive care units were rated as top performers. Of these, only 18 are public.

Among the private ones, there are names like Sírio-Libanês, in São Paulo, and Copa Star, in Rio de Janeiro. Among the public, the State Public Servant Hospital, in São Paulo, and Alberto Torres Hospital, a reference in São Gonçalo (RJ).

Rezende says that, before the pandemic, the total number of ICU beds in Brazil was divided between 60% private and 40% public. Today, the beds are half and half between public and private.

“There was an increase in the share of public beds in total. But, as the survey shows, many of the units in public hospitals are far from ideal or what would be adequate”, he says.

During the pandemic, Amib found that the mortality of patients with Covid admitted to private ICUs was 30%, while in public ICUs it reached 53%.

Check out the 135 hospitals that make up the high performance list.