The Impact Of The COVID-19 Pandemic On Hospital Admissions In The United States.
The Impact Of The COVID-19 Pandemic On Hospital Admissions In The United States.
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DOI：
10.1377/hlthaff.2020.00980
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发表时间：
2020-11
期刊：
影响因子：
--
通讯作者：
Skinner J
中科院分区：
文献类型：
--
作者：
Birkmeyer JD;Barnato A;Birkmeyer N;Bessler R;Skinner J
随着冠状病毒病2019年(新冠肺炎)大流行的爆发，美国的住院人数大幅下降。然而，人们对患者群体之间入院模式的差异或反弹的程度知之甚少。在这项研究中，我们对一个具有全国代表性的大型住院医师群体的大约100万名住院患者进行了研究，发现从2020年2月到4月，非新冠肺炎入院人数的下降在不同患者人口统计亚组中大致相似，所有初级入院诊断的下降幅度超过20%。到2020年6月底/7月初，非新冠肺炎入学总人数已反弹至比普及前基准量低16%(包括新冠肺炎入学人数8%)。居住在拉美裔占多数的社区的患者的非新冠肺炎入院率大大降低(比基线低32%)，肺炎(−44%)、慢性阻塞性肺疾病/哮喘(−40%)、败血症(−25%)、尿路感染(−24%)和急性ST段抬高心肌梗死(−22%)患者的入院时间仍远低于基线水平。卫生系统领导人和公共卫生当局应重点努力确保急性内科疾病患者在大流行期间能够根据需要获得医院护理，以避免不良后果。
Hospital admissions in the US fell dramatically with the onset of the coronavirus disease 2019 (COVID-19) pandemic. However, little is known about differences in admissions patterns among patient groups or the extent of the rebound. In this study of approximately one million medical admissions from a large, nationally representative hospitalist group, we found that declines in non-COVID-19 admissions from February to April 2020 were generally similar across patient demographic subgroups and exceeded 20 percent for all primary admission diagnoses. By late June/early July 2020, overall non-COVID-19 admissions had rebounded to 16 percent below prepandemic baseline volume (8 percent including COVID-19 admissions). Non-COVID-19 admissions were substantially lower for patients residing in majority-Hispanic neighborhoods (32 percent below baseline) and remained well below baseline for patients with pneumonia (−44 percent), chronic obstructive pulmonary disease/asthma (−40 percent), sepsis (−25 percent), urinary tract infection (−24 percent), and acute ST-elevation myocardial infarction (−22 percent). Health system leaders and public health authorities should focus on efforts to ensure that patients with acute medical illnesses can obtain hospital care as needed during the pandemic to avoid adverse outcomes.
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