Associations between reported healthcare disruption due to COVID-19 and avoidable hospitalisation: Evidence from seven linked longitudinal studies for England
Associations between reported healthcare disruption due to COVID-19 and avoidable hospitalisation: Evidence from seven linked longitudinal studies for England
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报告的因 COVID-19 造成的医疗保健中断与可避免的住院治疗之间的关联：来自英格兰七项相关纵向研究的证据
DOI：
10.1101/2023.02.01.23285333
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Green M
中科院分区：
文献类型：
--
作者：
Green M
背景在COVID-19大流行期间，英国各地的卫生服务都在努力应对。许多治疗被推迟或取消，尽管新的交付模式减轻了影响。虽然对这种破坏的规模进行了研究，但对这种破坏是否影响健康结果知之甚少。我们论文的目的是研究在大流行期间经历医疗保健中断的个人与可避免的住院风险之间是否存在关联。方法：我们使用英国纵向联系协作可信研究环境中与NHS Digital电子健康记录相关的七项纵向队列研究的个人水平数据（n = 29276）。可避免住院被定义为对门诊护理敏感和紧急紧急护理敏感的紧急住院（2020年3月1日至2022年8月25日）。我们使用自我报告的措施来衡量人们在大流行期间是否经历了预约（例如，去看全科医生或门诊）、程序（例如，手术、癌症治疗）或药物治疗的中断。逻辑回归模型检验了相关性。35%的人经历了某种形式的医疗服务中断。通道中断的患者在任何(优势比（OR) = 1.80, 95%可信区间(ci) = 1.34-2.41）、急性（OR = 1.68, ci = 1.13-2.53）和慢性（OR = 1.93, ci = 1.40-2.64）门诊敏感住院的风险均增加。预约中断与可避免住院措施的程序之间也存在积极联系。我们的研究从相关的个人层面数据中提供了新的证据，表明获得医疗保健服务中断的人更有可能获得可避免或潜在可预防的住院治疗。我们的研究结果强调，除了直接应对SARS-CoV-2感染外，还需要增加医疗保健投资，以应对大流行的短期和长期影响。
BackgroundHealth services across the UK struggled to cope during the COVID-19 pandemic. Many treatments were postponed or cancelled, although the impact was mitigated by new models of delivery. While the scale of disruption has been studied, much less is known about if this disruption impacted health outcomes. The aim of our paper is to examine whether there is an association between individuals experiencing disrupted access to healthcare during the pandemic and risk of an avoidable hospitalisation.MethodsWe used individual-level data for England from seven longitudinal cohort studies linked to electronic health records from NHS Digital (n = 29 276) within the UK Longitudinal Linkage Collaboration trusted research environment. Avoidable hospitalisations were defined as emergency hospital admissions for ambulatory care sensitive and emergency urgent care sensitive conditions (1stMarch 2020 to 25thAugust 2022). Self-reported measures of whether people had experienced disruption during the pandemic to appointments (e.g., visiting their GP or an outpatient department), procedures (e.g., surgery, cancer treatment) or medications were used as our exposures. Logistic regression models examined associations.Results35% of people experienced some form of disrupted access to healthcare. Those whose access was disrupted were at increased risk of any (Odds Ratio (OR) = 1.80, 95% Confidence Intervals (CIs) = 1.34-2.41), acute (OR = 1.68, CIs = 1.13-2.53) and chronic (OR = 1.93, CIs = 1.40-2.64) ambulatory care sensitive hospital admissions. There were positive associations between disrupted access to appointments and procedures to measures of avoidable hospitalisations as well.ConclusionsOur study presents novel evidence from linked individual-level data showing that people whose access to healthcare was disrupted were more likely to have an avoidable or potentially preventable hospitalisation. Our findings highlight the need to increase healthcare investment to tackle the short- and long-term implications of the pandemic beyond directly dealing with SARS-CoV-2 infections.
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影响因子：
4.1
作者：
McKinlay AR;Fancourt D;Burton A
通讯作者：
Burton A
DOI：
10.1016/s2468-2667(18)30068-9
发表时间：
2018-05
期刊：
The Lancet. Public health
影响因子：
--
作者：
Katikireddi SV;Cezard G;Bhopal RS;Williams L;Douglas A;Millard A;Steiner M;Buchanan D;Sheikh A;Gruer L
通讯作者：
Gruer L
影响因子：
14.6
作者：
Wang, Jonathan;Vahid, Saba;Irish, Jonathan
通讯作者：
Irish, Jonathan
英国不工作
影响因子：
--
作者：
M. McKee;L. Hiam
通讯作者：
L. Hiam
可预防的住院治疗和获得医疗保健的机会。
DOI：
10.1016/1062-1458(96)81082-8
发表时间：
1995
期刊：
JAMA
影响因子：
--
作者：
A. Bindman;A. Bindman;A. Bindman;K. Grumbach;K. Grumbach;K. Grumbach;D. Osmond;D. Osmond;D. Osmond;M. Komaromy;M. Komaromy;M. Komaromy;K. Vranizan;K. Vranizan;K. Vranizan;N. Lurie;N. Lurie;N. Lurie;J. Billings
通讯作者：
J. Billings