Impact of the Fall 2009 Influenza A(H1N1)pdm09 Pandemic on US Hospitals
Impact of the Fall 2009 Influenza A(H1N1)pdm09 Pandemic on US Hospitals
复制标题
DOI：
10.1097/mlr.0b013e31827da8ea
复制
发表时间：
2013-03-01
期刊：
影响因子：
3
通讯作者：
Lurie, Nicole
中科院分区：
文献类型：
--
作者：
Rubinson, Lewis;Mutter, Ryan;Lurie, Nicole
背景资料：了解医院在2009年甲型H1N1流感pdm 09大流行期间的运作方式可能会改善未来的公共卫生应急反应，但有关其对美国医院影响的信息在很大程度上仍然未知。研究设计：我们将来自医疗保健研究和质量机构（AHRQ）医疗保健成本和利用项目的医院和急诊科（艾德）出院数据与社区级流感进行了匹配-2009年秋季各医院流行期间的类似疾病活动与相应的日历基线期相比。我们比较了在高激增与nonsurge hospital.Results. Results的哨兵条件的住院死亡率：美国医院经历了一倍的肺炎和流感艾德访问在2009年秋季与前几年相比沿着18%的整体艾德访问增加。虽然总体上住院总人数没有显著增加，但所有研究医院中约有10%经历了高激增，与较高的急性心肌梗死和卒中病死率相关。这些医院与其他美国医院的特征相似，但在疫情爆发前，它们的急性心脏病死亡率较高。调整2008年的病死率，高浪涌医院和急性心肌梗死和中风patients. Conclusions死亡率增加之间的关联stressed.Conclusions：2009年秋季大流行期间大幅影响美国医院，主要是通过增加艾德访问。对于一小部分经历了住院人数激增的医院来说，某些临床疾病的死亡率增加与大流行前的结果和激增有关，突出了日常医院运营与备灾之间的联系。
Background: Understanding how hospitals functioned during the 2009 influenza A(H1N1)pdm09 pandemic may improve future public health emergency response, but information about its impact on US hospitals remains largely unknown.Research Design: We matched hospital and emergency department (ED) discharge data from the Agency for Healthcare Research and Quality (AHRQ) Healthcare Cost and Utilization Project with community-level influenza-like illness activity during each hospital's pandemic period in fall 2009 compared with a corresponding calendar baseline period. We compared inpatient mortality for sentinel conditions at high-surge versus nonsurge hospitals.Results: US hospitals experienced a doubling of pneumonia and influenza ED visits during fall 2009 compared with prior years, along with an 18% increase in overall ED visits. Although no significant increase in total inpatient admissions occurred overall, approximately 10% of all study hospitals experienced high surge, associated with higher acute myocardial infarction and stroke case fatality rates. These hospitals had similar characteristics to other US hospitals except that they had higher mortality for acute cardiac illnesses before the pandemic. After adjusting for 2008 case fatality rates, the association between high-surge hospitals and increased mortality for acute myocardial infarction and stroke patients persisted.Conclusions: The fall 2009 pandemic period substantially impacted US hospitals, mostly through increased ED visits. For a small proportion of hospitals that experienced a high surge in inpatient admissions, increased mortality from selected clinical conditions was associated with both prepandemic outcomes and surge, highlighting the linkage between daily hospital operations and disaster preparedness.