Associations between self-reported healthcare disruption due to covid-19 and avoidable hospital admission: evidence from seven linked longitudinal studies for England.
Associations between self-reported healthcare disruption due to covid-19 and avoidable hospital admission: evidence from seven linked longitudinal studies for England.
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DOI：
10.1136/bmj-2023-075133
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发表时间：
2023-07-19
影响因子：
105.7
通讯作者：
Katikireddi, Srinivasa Vittal
中科院分区：
文献类型：
--
作者：
Green, Mark A.;McKee, Martin;Hamilton, Olivia K. L.;Shaw, Richard J.;Macleod, John;Boyd, Andy;Katikireddi, Srinivasa Vittal
检验在新冠疫情期间医疗保健获取受阻的人群与可避免住院风险之间是否存在关联。
利用来自英格兰七项相关纵向队列研究的证据进行观察性分析。
研究与2020年3月1日至2022年8月25日英国国家医疗服务体系数字部门（NHS Digital）的电子健康记录相关联。数据是通过英国纵向关联协作可信研究环境获取的。
29276人的个体层面记录。
可避免住院定义为因门诊医疗敏感和急诊紧急医疗敏感病症的急诊住院。
9742名参与者（加权百分比为35%，根据纵向队列的样本结构进行了调整）自我报告在新冠疫情期间医疗保健获取存在某种形式的受阻情况。医疗保健获取受阻的人群发生任何门诊医疗敏感住院（优势比为1.80，95%置信区间为1.39 - 2.34）、急性（2.01，1.39 - 2.92）和慢性（1.80，1.31 - 2.48）的风险增加。对于那些就诊预约（例如，看医生或去门诊部）和医疗程序（例如，手术、癌症治疗）获取受阻的人群，发现其与可避免住院的指标呈正相关。
来自相关个体层面数据的证据表明，医疗保健获取受阻的人群更有可能发生潜在可预防的住院。研究结果强调需要增加医疗保健投资，以应对疫情的短期和长期影响，并在未来疫情期间保护治疗和医疗程序。
To examine whether there is an association between people who experienced disrupted access to healthcare during the covid-19 pandemic and risk of an avoidable hospital admission. Observational analysis using evidence from seven linked longitudinal cohort studies for England. Studies linked to electronic health records from NHS Digital from 1 March 2020 to 25 August 2022. Data were accessed using the UK Longitudinal Linkage Collaboration trusted research environment. Individual level records for 29 276 people. Avoidable hospital admissions defined as emergency hospital admissions for ambulatory care sensitive and emergency urgent care sensitive conditions. 9742 participants (weighted percentage 35%, adjusted for sample structure of longitudinal cohorts) self-reported some form of disrupted access to healthcare during the covid-19 pandemic. People with disrupted access were at increased risk of any (odds ratio 1.80, 95% confidence interval 1.39 to 2.34), acute (2.01, 1.39 to 2.92), and chronic (1.80, 1.31 to 2.48) ambulatory care sensitive hospital admissions. For people who experienced disrupted access to appointments (eg, visiting their doctor or an outpatient department) and procedures (eg, surgery, cancer treatment), positive associations were found with measures of avoidable hospital admissions. Evidence from linked individual level data shows that people whose access to healthcare was disrupted were more likely to have a potentially preventable hospital admission. The findings highlight the need to increase healthcare investment to tackle the short and long term implications of the pandemic, and to protect treatments and procedures during future pandemics.
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作者：
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期刊：
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