Socioeconomic deprivation and ethnicity inequalities in disruption to NHS hospital admissions during the COVID-19 pandemic: a national observational study.
Socioeconomic deprivation and ethnicity inequalities in disruption to NHS hospital admissions during the COVID-19 pandemic: a national observational study.
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DOI：
10.1136/bmjqs-2021-013942
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发表时间：
2022-08
影响因子：
5.4
通讯作者：
Propper C
中科院分区：
文献类型：
--
作者：
Warner M;Burn S;Stoye G;Aylin PP;Bottle A;Propper C
在COVID-19大流行开始时，许多国家的住院人数急剧下降。对于不同患者群体的护理模式有何不同，我们所知甚少。我们试图确定在英格兰，社会经济剥夺程度较高或少数民族人口较多的地区，紧急和计划入院人数是否下降得更大。我们在2019-2020年对英国国家卫生服务体系（NHS）的医院护理进行了一项全国性观察性研究。与2019年相比，计算了2020年每个人口普查区每周选修（计划）和紧急入院人数。在控制了国家时间趋势和当地区域构成后，采用多元线性回归分析估计了不同社会经济剥夺五分位数地区和少数民族人口的减少量。与2019年相比，2020年3月至12月期间，非covid -19初级诊断的选择性入院人数减少了35.5%（300万），急诊入院人数减少了22.0%（120万）。与少数民族人口比例最小的地区相比，少数民族人口比例最大的地区非原发性COVID-19急诊入院率下降了36.7% （95% CI 24.1%至49.3%）。与最贫困地区相比，最贫困地区非covid -19急诊入院人数减少了10.1% （95% CI 2.6%至17.7%）。这些模式不能用不同地区COVID-19病例流行率的差异来解释。即使在建立在平等需求平等机会原则基础上的医疗保健系统中，COVID-19对英格兰非covid患者的NHS医院护理的影响也没有按种族和贫困均匀分布。虽然我们无法最终确定这些差异背后的机制，但它们有可能加剧大流行前的卫生不平等。
Hospital admissions in many countries fell dramatically at the onset of the COVID-19 pandemic. Less is known about how care patterns differed by patient groups. We sought to determine whether areas with higher levels of socioeconomic deprivation or larger ethnic minority populations saw larger falls in emergency and planned admissions in England. We conducted a national observational study of hospital care in the English National Health Service (NHS) in 2019–2020. Weekly volumes of elective (planned) and emergency admissions in 2020 compared with 2019 were calculated for each census area. Multiple linear regression analysis was used to estimate the reductions in volumes for areas in different quintiles of socioeconomic deprivation and ethnic minority populations after controlling for national time trends and local area composition. Between March and December 2020, there were 35.5% (3.0 million) fewer elective admissions and 22.0% (1.2 million) fewer emergency admissions with a non-COVID-19 primary diagnosis than in 2019. Areas with the largest share of ethnic minority populations experienced a 36.7% (95% CI 24.1% to 49.3%) larger reduction in non-primary COVID-19 emergency admissions compared with those with the smallest. The most deprived areas experienced a 10.1% (95% CI 2.6% to 17.7%) smaller reduction in non-COVID-19 emergency admissions compared with the least deprived. These patterns are not explained by differential prevalence of COVID-19 cases by area. Even in a healthcare system founded on the principle of equal access for equal need, the impact of COVID-19 on NHS hospital care for non-COVID patients has not been spread evenly by ethnicity and deprivation in England. While we cannot conclusively determine the mechanisms behind these differences, they risk exacerbating prepandemic health inequalities.
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影响因子：
30.8
作者：
Mansfield, Kathryn E.;Mathur, Rohini;Langan, Sinead M.
通讯作者：
Langan, Sinead M.
影响因子：
5.4
作者：
Bogh, Soren Bie;Flojstrup, Marianne;Brabrand, Mikkel
通讯作者：
Brabrand, Mikkel
DOI：
10.1377/hlthaff.2020.00980
发表时间：
2020-11
期刊：
Health affairs (Project Hope)
影响因子：
--
作者：
Birkmeyer JD;Barnato A;Birkmeyer N;Bessler R;Skinner J
通讯作者：
Skinner J
影响因子：
7.3
作者：
Propper, Carol;Stoye, George;Zaranko, Ben
通讯作者：
Zaranko, Ben
DOI：
10.1101/2020.06.06.20120857v1.full
发表时间：
2020-10-23
影响因子：
33.9
作者：
Rossen, Lauren M.;Branum, Amy M.;Anderson, Robert N.
通讯作者：
Anderson, Robert N.