Healthcare Utilization Among Patients Diagnosed with COVID-19 in a Large Integrated Health System.
Healthcare Utilization Among Patients Diagnosed with COVID-19 in a Large Integrated Health System.
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大型综合卫生系统中诊断为COVID-19的患者的医疗保健利用。
DOI：
10.1007/s11606-021-07139-z
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发表时间：
2022-03
影响因子：
5.7
通讯作者：
Sharp AL
中科院分区：
文献类型：
--
作者：
Huang BZ;Creekmur B;Yoo MS;Broder B;Subject C;Sharp AL
COVID-19诊断后对医疗资源的需求很大，但目前尚未量化。描述确诊为COVID-19的患者在180天内的医疗保健利用趋势，并确定与医疗保健利用增加相关的患者因素。观察性队列研究。于2020年3月至9月期间，在南加州的一个大型综合医疗保健系统中，共有64，011名患者经测试确诊为COVID-19。COVID-19确诊后180天内的整体医疗保健利用率，以及前30天内的就诊类型和就诊原因。Poisson回归用于确定与较高利用率相关的患者因素。对因COVID-19住院和未住院的患者分别进行了分析。在所有时间段，住院患者的医疗保健利用率约为非住院患者的两倍。平均就诊次数在头30天最多（住院：12.3次/30人-日;非住院：6.6次），并随着时间的推移逐渐减少。在前30天，大多数医疗保健访问是远程医疗（住院：9.0次访问;非住院：5.6次访问），最常见的访问原因是COVID相关诊断，COVID相关症状和泌尿系统相关疾病。对于住院患者，年龄较大（≥65：RR 1.27，95% CI 1.15-1.41）、女性（RR 1.07，95% CI 1.05-1.09）和BMI较高（≥40：RR 1.07，95% CI 1.03-1.10）与总利用率较高相关。对于非住院患者，年龄较大、女性、BMI较高、非白人人种/种族、既往吸烟和既往合并症数量较多均与利用率增加相关。COVID-19患者在确诊后30天内频繁寻求医疗保健，对卫生系统提出了很高的要求。在我们从疫情中恢复的过程中，确定支持确诊患有COVID-19的患者的方法，同时为我们的社区提供适当的常规推荐护理将非常重要。在线版本包含补充材料，可通过10.1007/s11606-021-07139-z获得。
The demands for healthcare resources following a COVID-19 diagnosis are substantial, but not currently quantified. To describe trends in healthcare utilization within 180 days for patients diagnosed with COVID-19 and identify patient factors associated with increased healthcare use. Observational cohort study. A total of 64,011 patients with a test-confirmed COVID-19 diagnosis from March to September 2020 in a large integrated healthcare system in Southern California. Overall healthcare utilization during the 180 days following COVID-19 diagnosis, as well as encounter types and reasons for visits during the first 30 days. Poisson regression was used to identify patient factors associated with higher utilization. Analyses were performed separately for patients who were and were not hospitalized for COVID-19. Healthcare utilization was about twice as high for hospitalized patients compared to non-hospitalized patients in all time periods. The average number of visits was highest in the first 30 days (hospitalized: 12.3 visits/30 person-days; non-hospitalized: 6.6) and gradually decreased over time. In the first 30 days, the majority of healthcare visits were telehealth encounters (hospitalized: 9.0 visits; non-hospitalized: 5.6 visits), and the most prevalent reasons for visits were COVID-related diagnoses, COVID-related symptoms, and respiratory-related conditions. For hospitalized patients, older age (≥65: RR 1.27, 95% CI 1.15–1.41), female gender (RR 1.07, 95% CI 1.05–1.09), and higher BMI (≥40: RR 1.07, 95% CI 1.03–1.10) were associated with higher total utilization. For non-hospitalized patients, older age, female gender, higher BMI, non-white race/ethnicity, former smoking, and greater number of pre-existing comorbidities were all associated with increased utilization. Patients with COVID-19 seek healthcare frequently within 30 days of diagnosis, placing high demands on health systems. Identifying ways to support patients diagnosed with COVID-19 while adequately providing the usual recommended care to our communities will be important as we recover from the pandemic. The online version contains supplementary material available at 10.1007/s11606-021-07139-z.
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影响因子：
3.9
作者：
Dugail, Isabelle;Amri, Ez-Zoubir;Vitale, Nicolas
通讯作者：
Vitale, Nicolas
影响因子：
13.8
作者：
Ioannou GN;Locke E;Green P;Berry K;O'Hare AM;Shah JA;Crothers K;Eastment MC;Dominitz JA;Fan VS
通讯作者：
Fan VS
DOI：
10.1016/j.lanepe.2021.100046
发表时间：
2021-03
期刊：
The Lancet regional health. Europe
影响因子：
--
作者：
Annane D;Federici L;Chagnon JL;Diehl JL;Dreyfuss D;Guiot P;Javouhey E;Joram N;Lesieur O;Rigaud JP;Outin H;Sement A;Sevens C;Thévenin D;Touati S;Terzi N;Trade Union of Intensive Care Physicians
通讯作者：
Trade Union of Intensive Care Physicians
影响因子：
39.2
作者：
Anderson, Michaela R.;Geleris, Joshua;Baldwin, Matthew R.
通讯作者：
Baldwin, Matthew R.
影响因子：
2.1
作者：
Klepser, Donald G.;Corn, Carolyn E.;Klepser, Michael E.
通讯作者：
Klepser, Michael E.