Impact of state of emergency for coronavirus disease 2019 on hospital visits and disease exacerbation: the Japan COVID-19 and Society Internet Survey
Impact of state of emergency for coronavirus disease 2019 on hospital visits and disease exacerbation: the Japan COVID-19 and Society Internet Survey
复制标题
DOI：
10.1093/fampra/cmac016
复制
发表时间：
2022-03-28
期刊：
影响因子：
2.2
通讯作者：
Tabuchi, Takahiro
中科院分区：
文献类型：
--
作者：
Yoshida, Satomi;Okubo, Ryo;Tabuchi, Takahiro
关于冠状病毒病2019年(新冠肺炎)对人们日常医疗或就诊的影响的研究很少。重要的是要了解与避免住院有关的因素，以便了解这一大流行。因此，我们评估了日本宣布紧急状态和居家命令对就诊和疾病恶化的影响；我们还确定了一些相关的风险因素。我们包括7,747名日本新冠肺炎和协会互联网调查的参与者，他们报告有一些疾病，如精神疾病、慢性疼痛和头痛、糖尿病、心血管疾病和癌症。我们评估了慢性病与逃避就诊结果之间的关系，我们的发现表明，病情恶化主要发生在患有精神疾病、慢性疼痛和头痛以及糖尿病的参与者中。虽然我们的研究只关注医院/诊所的就诊情况，没有考虑包括死亡率在内的急性医疗保健，但在新冠肺炎在家治疗政策下，不同疾病患者的回避就诊和病情恶化的比率有所不同。在大流行期间跟踪患有精神疾病的患者尤其重要，有必要制定具体疾病的规划。关于冠状病毒病2019年(新冠肺炎)对人们常规医疗保健影响的背景研究有限，了解与避免医疗保健相关的因素可以让我们了解正在进行的大流行。目的评估日本新冠肺炎紧急状态和居家政策对出院人次和疾病恶化的影响，并找出相关因素。方法这项横断面研究使用了来自日本新冠肺炎和社会互联网调查(JACSIS)的数据，其中包括随机抽样的在日本的研究机构小组成员。在28,000名参与者中，我们包括7,747名报告患有任何疾病的受访者。我们描述了基线特征和回避相关的医院就诊结果。我们使用多变量Logistic回归分析来评估慢性病与逃避就诊结果之间的关系。结果在7,747名参与者中，17.7%的慢性病患者避免就诊，2.1%的患者推迟住院或手术，4.9%的患者用完药物，5.3%的患者在2020年4-5月新冠肺炎疫情期间经历疾病恶化。恶化主要发生在患有精神疾病、慢性疼痛和头痛的参与者以及糖尿病患者(OR分别为3.33[95%可信区间：2.51-4.41]、2.83[95%可信区间：2.19-3.66]和1.53[95%可信区间：1.10-2.13])。患有心血管疾病或癌症的患者未发生恶化[OR0.55(95%CI：0.31~0.97)，0.79(95%CI：0.43~1.45)]。结论2020年4月和5月新冠肺炎留守政策下不同疾病患者的回避就诊率和病情加重率不同，可能需要针对疾病进行针对性的准备。
Lay Summary There are few studies available on the effect of coronavirus disease 2019 (COVID-19) on people's routine medical care or hospital visits. It is important to understand the factors associated with hospital avoidance in order to be informed about this pandemic. Therefore, we assessed how the declaration of a state of emergency and a stay-at-home order in Japan affected hospital visits and the worsening of diseases; we also identified some risk factors involved. We included 7,747 participants of the Japan COVID-19 and Society Internet Survey, who reported having conditions, such as mental diseases, chronic pain and headache, diabetes, cardiovascular diseases, and cancer. We evaluated the association between chronic diseases and outcomes of hospital visits avoidance, and our findings showed that exacerbations occurred mostly in participants with mental diseases, chronic pain and headache, and diabetes. Though our study only focussed on hospital/clinic visits and did not consider acute health care, including mortality, the rates of hospital visits avoidance and exacerbation varied among patients with different diseases under the COVID-19 stay-at-home policy. It is particularly important to follow up patients with mental diseases during the pandemic, and disease-specific planning is necessary.Background Studies on the impact of coronavirus disease 2019 (COVID-19) on people's routine medical care are limited, and understanding the factors associated with medical care avoidance can inform us about the ongoing pandemic. Objectives We aimed to assess the impact of Japan's state of emergency and stay-at-home policy for COVID-19 on hospital visits and disease exacerbation; we also identified related factors. Methods This cross-sectional study used data from the Japan COVID-19 and Society Internet Survey (JACSIS), which included randomly sampled research agency panellists in Japan. Among the 28,000 participants, we included 7,747 respondents who reported having any disease. We described baseline characteristics and avoidance-related hospital visit outcomes. We used multivariable logistic regression analyses to assess the association between chronic diseases and outcomes of hospital visit avoidance. Results Among 7,747 participants, 17.7% of patients with chronic diseases avoided hospital visits, 2.1% of patients postponed hospitalization or surgery, 4.9% of patients ran out of drug, and 5.3% of patients experienced disease exacerbation during the COVID-19 pandemic in April and May 2020. Exacerbations occurred mostly in participants with mental diseases, chronic pain and headache, and diabetes (OR 3.33 [95% confidence interval (CI): 2.51-4.41], 2.83 [95% CI: 2.19-3.66], and 1.53 [95% CI: 1.10-2.13], respectively). Patients with cardiovascular disease or cancer did not experience exacerbation [OR 0.55 (95% CI: 0.31-0.97), 0.79 (95% CI: 0.43-1.45)]. Conclusions The rates of hospital visit avoidance and exacerbation varied among patients with different diseases under the COVID-19 stay-at-home policy in April and May 2020, and disease-specific preparedness may be necessary for the pandemic.