Factors associated to patients' referral to public or private Covid-19 healthcare centers in Tabriz, Iran.

BACKGROUND: In Iran, tracking of patients and its associated data recording in private healthcare centers are poor, and thus a majority of patients suffering from Covid-19 are treated without any control on the isolation and quarantine processes. The present study aims to investigate the factors contributed to referral to private or public healthcare centers that provide Covid-19 care services. METHODS: This cross-sectional study was conducted from November 2021 to January 2022 in Tabriz, Iran. We invited a total of 258 and 202Covid-19 patients from governmental and private healthcare centers, respectively, to participate in the study by convenient sampling method. Applying a self-administered questionnaire, we collected data on the reason of referring to the healthcare centers, patient's waiting time, quality of healthcare services received by the patients, patients' level of satisfaction, accessibility, insurance coverage, perceived severity of the disease, and the level of staff compliance from health protocols. Logistic regression model was used for data analysis by using SPSS-26 software. RESULTS: Adjusted for other variables, higher socio-economic status (AOR (Adjusted Odds Ratio) = 6.64), older age (AOR = 1.02), referral of friends and family members (AOR = 1.52), shorter waiting time (AOR = 1.02) and higher satisfaction (AOR = 1.02) were contributed to referral to private centers. Better accessibility (AOR = 0.98) and wider insurance coverage (AOR = 0.99) were also contributed to referral to governmental centers. CONCLUSION: Providing more appropriate insurance coverage by private healthcare centers, and promoting their level of accessibility seems to promote patients' referral to such centers. Moreover, establishing an accurate system for recording patients' information and follow up in private centers might promote the role of private healthcare centers in managing the overload of patients on healthcare system during such epidemics.

Investigation of the Factors Related to Mortality and Length of Hospitalization among COVID-19 Patients in East Azerbaijan Hospitals, Iran.

BACKGROUND: It is of utmost importance to identify populations with an elevated risk for COVID-19 and the factors influencing its outcomes. The present study aimed to investigate factors affecting mortality and length of stay (LOS) among COVID-19 patients in the hospitals of East Azerbaijan province, Iran, during 15 months of this pandemic. STUDY DESIGN: The present study followed a retrospective cohort design. METHODS: This retrospective study was conducted using data in the integrated syndromic surveillance system (ISSS) on patients admitted to the hospitals from February 21, 2020, to April 11, 2021. The association between variables of interest and death, as well as LOS, was investigated via multiple logistic regression and multiple linear regression analyses. RESULTS: In total, 24 293 inpatients with a mean age of 54.0 ± 19.4 years were included in this study. About 15% of them lost their lives, whose mean age was 69.0 ± 14.6 years, significantly higher than the recovered ones (P < 0.001). Factors, such as above 49 years of age (P < 0.001), male gender (OR = 1.17; 95% CI: 1.08-1.26), and having chronic diseases (OR = 1.32; 95% CI: 1.22-1.42), were correlated with patient mortality. In addition, having chronic diseases (Beta = 0.06; 95% CI: 0.03-0.08) was associated with higher LOS in hospitals. CONCLUSION: In conclusion, older patients were at a higher risk of mortality and prolonged hospitalization. Furthermore, patients' underlying diseases could cause a severe form of COVID-19, which can lead to death and increase patients' LOS.