Urban-Rural Differences in Health Care Utilization and COVID-19 Outcomes in Patients With Type 2 Diabetes.
Urban-Rural Differences in Health Care Utilization and COVID-19 Outcomes in Patients With Type 2 Diabetes.
复制标题
DOI：
10.5888/pcd19.220015
复制
发表时间：
2022-07-21
影响因子：
5.5
通讯作者：
Schwartz, Brian S.
中科院分区：
文献类型：
--
作者：
Hirsch, Annemarie G.;Nordberg, Cara M.;Bandeen-Roche, Karen;Pollak, Jonathan;Poulsen, Melissa N.;Moon, Katherine A.;Schwartz, Brian S.
宾夕法尼亚州的两项研究旨在确定社区类型和社区社会经济剥夺（CSD）1）是否改变了2型糖尿病（以下简称糖尿病）与COVID-19住院结局之间的关联，以及2）是否影响了COVID-19大流行期间糖尿病患者的医疗保健利用。住院研究对2020年因COVID-19住院的患者进行了回顾性队列评估，以评估COVID-19的结局：死亡、重症监护室（ICU）入院、机械通气、D-二聚体升高和肌钙蛋白水平升高。我们使用调整后的逻辑回归模型，添加交互作用项，以评估社区类型（乡镇，自治市，或城市人口普查区）和CSD的影响修改。利用研究包括糖尿病患者和2017年至2020年之间的临床遭遇。自回归综合移动平均时间序列模型评估了2018年至2020年期间急诊和门诊每周就诊率、血红蛋白A1 c（HbA 1c）实验室检查和抗高血糖药物订单的变化。在住院研究中，2，751名因COVID-19住院的患者中，1，020名患有糖尿病，这与ICU住院和肌钙蛋白升高有关。协会没有不同的社区类型或CSD。在利用研究中，在93，401名糖尿病患者中，利用指标在2020年3月下降。利用率在7月份有所增加，然后在2020年底开始稳定或下降。大流行期间HbA 1c检测和用药顺序趋势的变化因社区类型和CSD而异。糖尿病与因COVID-19住院的个体的选定结果相关，但这些结果在社区特征方面没有差异。在大流行期间，糖尿病患者的使用轨迹受到社区类型和CSD的影响，可用于识别糖尿病护理缺口风险的个体。
Two studies in Pennsylvania aimed to determine whether community type and community socioeconomic deprivation (CSD) 1) modified associations between type 2 diabetes (hereinafter, diabetes) and COVID-19 hospitalization outcomes, and 2) influenced health care utilization among individuals with diabetes during the COVID-19 pandemic. The hospitalization study evaluated a retrospective cohort of patients hospitalized with COVID-19 through 2020 for COVID-19 outcomes: death, intensive care unit (ICU) admission, mechanical ventilation, elevated D-dimer, and elevated troponin level. We used adjusted logistic regression models, adding interaction terms to evaluate effect modification by community type (township, borough, or city census tract) and CSD. The utilization study included patients with diabetes and a clinical encounter between 2017 and 2020. Autoregressive integrated moving average time-series models evaluated changes in weekly rates of emergency department and outpatient visits, hemoglobin A1c (HbA1c) laboratory tests, and antihyperglycemic medication orders from 2018 to 2020. In the hospitalization study, of 2,751 patients hospitalized for COVID-19, 1,020 had diabetes, which was associated with ICU admission and elevated troponin. Associations did not differ by community type or CSD. In the utilization study, among 93,401 patients with diabetes, utilization measures decreased in March 2020. Utilization increased in July, and then began to stabilize or decline through the end of 2020. Changes in HbA1c tests and medication order trends during the pandemic differed by community type and CSD. Diabetes was associated with selected outcomes among individuals hospitalized for COVID-19, but these did not differ by community features. Utilization trajectories among individuals with diabetes during the pandemic were influenced by community type and CSD and could be used to identify individuals at risk of gaps in diabetes care.
登录
查看更多内容
影响因子：
16.2
作者：
Longmore DK;Miller JE;Bekkering S;Saner C;Mifsud E;Zhu Y;Saffery R;Nichol A;Colditz G;Short KR;Burgner DP;International BMI-COVID consortium
通讯作者：
International BMI-COVID consortium
DOI：
10.1016/j.dsx.2020.09.035
发表时间：
2020-11
期刊：
Diabetes & metabolic syndrome
影响因子：
--
作者：
Mishra Y;Pathak BK;Mohakuda SS;Tilak TVSVGK;Sen S;P H;Singh R;Singh AR
通讯作者：
Singh AR
影响因子：
16.2
作者：
Selvin, Elizabeth;Juraschek, Stephen P.
通讯作者：
Juraschek, Stephen P.
DOI：
10.1016/j.ijid.2021.02.113
发表时间：
2021-04
期刊：
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
影响因子：
--
作者：
Wibowo A;Pranata R;Akbar MR;Purnomowati A;Martha JW
通讯作者：
Martha JW
DOI：
10.1016/j.dsx.2021.05.016
发表时间：
2021-07
期刊：
Diabetes & metabolic syndrome
影响因子：
--
作者：
Raghavan A;Nanditha A;Satheesh K;Susairaj P;Vinitha R;Chandrasekaran S;Palaniappan T;Thillai Vallal S;Subair Khan A;Snehalatha C;Ramachandran A
通讯作者：
Ramachandran A