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CC BY 4.0 · Arq Neuropsiquiatr 2025; 83(06): s00451809418
DOI: 10.1055/s-0045-1809418
Original Article

The influence of hospital type (public versus private) on mortality and survival after stroke

Authors

  • Carla Heloisa Cabral Moro 

    1   Hospital Municipal São José, Departamento de Neurologia, Joinville SC, Brazil.

  • Maria Izabel Rodrigues Mendes 

    2   Universidade da Região de Joinville, Faculdade de Medicina, Joinville SC, Brazil.

  • Milena Veiga Wiggers 

    2   Universidade da Região de Joinville, Faculdade de Medicina, Joinville SC, Brazil.

  • Thaís de Faria Cardoso 

    2   Universidade da Região de Joinville, Faculdade de Medicina, Joinville SC, Brazil.

  • Henrique Diegoli 

    3   Academia VBHC, São Paulo SP, Brazil.

  • Luciano Henrique Pinto 

    2   Universidade da Região de Joinville, Faculdade de Medicina, Joinville SC, Brazil.

  • Helbert do Nascimento Lima 

    1   Hospital Municipal São José, Departamento de Neurologia, Joinville SC, Brazil.
    4   Universidade da Região de Joinville, Programa de Pós-Graduação em Saúde e Meio Ambiente, Joinville SC, Brazil.
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Abstract

Background

Stroke has been a leading cause of death in Brazil throughout the past three decades. Although several cities in the country have implemented urgent/emergency stroke care units, the impact of the hospital type (public versus private) has not been evaluated.

Objective

To compare the mortality and survival of patients admitted with stroke to two private hospitals without stroke units with a public hospital with a stroke unit.

Methods

We conducted a historical cohort in the city of Joinville, Southern Brazil. Stroke patients admitted to a public hospital with a stroke unit were compared with those admitted to private hospitals without stroke units in terms of fatality rate and 30-day survival between January 2018 and December 2020. The Cox regression was used.

Results

Of the 4,508 patients, 85.6% were from public hospital, and 14.4%, from the 2 private hospitals. The crude mortality rate was of 11.4% among the public hospital patients, and of 9.1% among the patients from the private hospitals (p = 0.085). In the multivariate analysis, there was no difference in mortality between patients treated in the public hospital with a stroke unit (hazard ratio = 1.21; 95%CI: 0.87–1.68; p = 0.262) and those admitted to the 2 private hospitals without a stroke unit.

Conclusion

Stroke units are an important public policy that minimizes the impact of stroke.

Keywords

Stroke - Survival Analysis - Health Care Economics and Organizations

Authors' Contributions

Conceptualization: CHCM, LHP, HNL; Data curation: CHCM, LHP, HNL; Formal analysis: HNL; Investigation: HNL; Project administration: LHP, HNL; Validation: CHCM, LHP, HNL, MIRM, MVW, TFC; Visualization: CHCM, LHP, HNL, MIRM, MVW, TFC; Writing - original draft: CHCM, LHP, HNL, MIRM, MVW, TFC, HD; Writing - review & editing: CHCM, LHP, HNL, MIRM, MVW, TFC, HD.


Data Availability Statement

The data supporting the findings of the present article cannot be made publicly available because they contain sensitive information about the participants and hospitals involved. The data are available from the authors upon reasonable request.


Editor-in-Chief: Ayrton Roberto Massaro 0000-0002-0487-5299.


Associate Editor: Marcos Christiano Lange 0000-0002-0405-7157.




Publikationsverlauf

Eingereicht: 19. November 2024

Angenommen: 06. April 2025

Artikel online veröffentlicht:
20. Juni 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Carla Heloisa Cabral Moro, Maria Izabel Rodrigues Mendes, Milena Veiga Wiggers, Thaís de Faria Cardoso, Henrique Diegoli, Luciano Henrique Pinto, Helbert do Nascimento Lima. The influence of hospital type (public versus private) on mortality and survival after stroke. Arq Neuropsiquiatr 2025; 83: s00451809418.
DOI: 10.1055/s-0045-1809418