Spatial analysis of live birth clusters in Unified Health System (SUS) and private hospitals in the municipality of São Paulo, Brazil

• Published in: Ciência & saude coletiva Vol. 19; no. 1; pp. 235 - 244
• Main Authors: dos Santos, Patrícia Carla, da Silva, Zilda Pereira, Chiaravalloti Neto, Francisco, de Almeida, Marcia Furquim
• Format: Journal Article
• Language: Portuguese
• Published: Brazil 01.01.2014
• Subjects: Brazil; Delivery of Health Care; Delivery, Obstetric - statistics & numerical data; Hospitals, Private; Humans; Live Birth; Spatial Analysis; Brazil
• ISSN: 1678-4561
• DOI: 10.1590/1413-81232014191.1943

The scope of this study is to evaluate the spatial distribution of live births (LB) in the Municipality of São Paulo (MSP), verify if there is spatial dependence, identify possible differences in birth profiles and evaluate the distances between homes and delivery hospitals. LB occurring in high complexity hospitals were studied, namely 4 from the Unified Health System (SUS) and 4 from the private network in MSP in 2008. 46,190 LB were geocoded: 48.8% from SUS hospitals and 51.2% from private hospitals, accounting for 27.9% of total live births in MSP. LB in SUS hospitals formed two clusters, with a high proportion of households with incomes of 1/2 to 2MW and a marked number of shantytowns and high birth rates. LB in private hospitals formed a cluster in the central region of MSP, where there is a high proportion of households with > 10 MW income and a low birth rate. Differences in maternal, pregnancy and childbirth characteristics were statistically significant in SUS and non-SUS hospitals, as well as the frequency of multiple births. There was no difference in the prevalence of low birth weight and pre-term births. The results showed differences in the LB cluster profile reflecting the current inequalities in living conditions.