COVID-19 and Acute Medical Care: Impact on Dementia Patients

COVID-19 和紧急医疗护理：对痴呆症患者的影响

• 批准号: 10168228
• 负责人: JOHN HSU
• 金额: $ 65.42万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-30 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10168228
• 关键词: 2019-nCoV; Accident and Emergency department; Accounting; Acute; Acute myocardial infarction; Address; Affect; Area; Attention; Beds; COVID-19; Caring; Cessation of life; Clinical; Clinical Data; Country; Critical Care; Crowding; Data; Data Sources; Death Certificates; Dementia; Diagnosis; Disease; Disease Outbreaks; Documentation; Elderly; Electronic Health Record; Event; Family health status; Frequencies; Future; Health system; Healthcare; Heterogeneity; Home environment; Hospitalization; Hospitals; Infection; Intervention; Lead; Link; Massachusetts; Measures; Medical; Methods; Modeling; Myocardial Infarction; Outcome; Patient-Focused Outcomes; Patients; Pattern; Population; Preparation; Procedures; Reporting; Resource Allocation; Resources; Seizures; Sentinel; Services; Shock; Stress; Stroke; Subgroup; Sum; System; Test Result; Testing; Time; Uncertainty; Vaccines; Virus; Virus Diseases; Visit; Vulnerable Populations; Waxes; care seeking; comparative; coronavirus disease; cost; disease transmission; experience; falls; high risk; improved; intervention effect; meetings; mortality risk; novel; older patient; pandemic disease; preventable death; response; spatial relationship; telehealth; time use

Abstract. The SARS-CoV-2 virus has resulted in hundreds of thousands of deaths across the globe and overwhelmed many health systems. In Massachusetts alone, there have been over five thousand deaths over a two month period attributable directly to COVID-19, i.e., the disease resulting from viral infection. Lacking a vaccine or definitive treatment, slowing disease spread such that daily demand falls within the capacity of local medical systems is the immediate priority for this outbreak, but the changes involved with such mitigation efforts could be costly. For example, many hospitals have implemented changes to increase capacity for COVID-19 patients, e.g., delaying elective procedures and shifting resources across service lines, which could impact care for other conditions requiring time-sensitive care, e.g., strokes or heart attacks. There currently is limited information on the impact of the outbreak on non-infection, acute medical conditions. There also is little information on how hospital responses impact patient outcomes. Given concerns about future outbreaks in other states, as well as additional repeat outbreaks (or waves of disease transmission), there is a critical need for these types of information. In this project, we will address two aims: 1) to examine the impact of the COVID-19 demand shock on acute medical care received in the Emergency Department (ED) or hospital; and 2) to examine hospital responses to the demand shock and their impact on clinical event rates. We will use novel, linked real-time data sources to address these questions overall and for vulnerable population subgroups such as patient with dementia. Indeed, the early reports suggest that the elderly are disproportionally affected by COVID-19 itself and potentially the health system’s changes in response to the outbreak. These data could inform preparation for future COVID-19 outbreak waves occurring later this year, as well as future transmissible disease outbreaks.

抽象的。 SARS-CoV-2病毒已导致全球数十万人死亡， 使许多卫生系统不堪重负。仅在马萨诸塞州，就有超过5个 在两个月内有1000人直接死于新冠肺炎，即这种疾病 由病毒感染引起的。缺乏疫苗或明确的治疗方法，减缓疾病传播 使每天的需求落在当地医疗系统的能力范围内是迫在眉睫的 这是本次疫情的优先事项，但这种缓解努力所涉及的变化可能代价高昂。 例如，许多医院已经实施了改变，以增加新冠肺炎的容量 患者，例如，推迟选择性程序和跨服务线路转移资源，这 可能会影响其他需要时间敏感型护理的疾病的护理，例如中风或心脏 袭击。目前关于疫情对非感染的影响的信息有限， 严重的医疗状况。关于医院反应如何影响的信息也很少。 病人的结果。鉴于对其他州未来疫情的担忧，以及其他 重复爆发(或疾病传播的浪潮)，迫切需要这些类型的 信息。在这个项目中，我们将着眼于两个目标：1)研究新冠肺炎的影响 急诊科(ED)或医院接受的急性医疗护理需求冲击； 2)检查医院对需求冲击的反应及其对临床事件的影响 费率。我们将使用新颖、链接的实时数据源来全面解决这些问题，并 适用于弱势群体，如痴呆症患者。事实上，早期的报告 表明老年人不成比例地受到新冠肺炎本身以及潜在的 卫生系统因应疫情而发生的变化。这些数据可以为 今年晚些时候发生的未来新冠肺炎疫情以及未来的传播性 疾病暴发。