2019年コロナウイルス感染症のパンデミック中のホームビジットケア利用とアウトカムの変化:がんとがんのない患者の比較
Yu Sun1,2,3, Jun Komiyama1,2, Atsushi Miyawaki4
1Department of Health Services Research, Institute of Medicine, University of Tsukuba.
Journal of epidemiology
|February 23, 2026
まとめ
COVID-19のパンデミックは,高齢者,特にがん患者に対する医師主導の家庭訪問ケアを増加させました. がん患者は,死亡率が増加し,入院数が減少したなど,自宅での終末期ケアへの移行がより顕著であった.
科学分野:
- ゲロントロジーはゲロントロジーの学科です.
- 腫瘍学 腫瘍学
- 公衆衛生は公衆衛生である.
背景:
- COVID-19のパンデミックは,特にがん患者である,ホームバインドされた高齢者の医療へのアクセスに大きく影響しました.
- 障害は,脆弱な集団のためのケア提供モデルの再評価を必要とした.
研究 の 目的:
- COVID-19のパンデミック期間中に,がんとがんのない高齢の日本人の患者に対する医師主導の自宅訪問ケアの開始と結果の変化を比較する.
- ホームケアを開始してから90日以内に,死亡率と入院率に対するパンデミックの影響を評価する.
主な方法:
- 日本の65歳以上の患者からの国内医療主張データを用いた遡及的観察研究.
- パンデミック前 (2018年4月~2019年12月) とパンデミック前 (2020年1月~12月) の期間を比較する.
- 癌の診断による分層分析と,相互作用項を伴う線形回帰モデルの使用.
主要な成果:
- ホーム・ビジット・ケア開始は,がんと非がんの両方のグループで,パンデミック期間中に増加しました.
- 全原因および家庭での死亡率は上昇し,入院率は両方のグループで減少した.
- がん患者はより顕著な変化を示した:全原因による死亡が1.6%増加し,自宅での死亡が3.8%増加し,入院が2.9%減少した.
結論:
- 医者が主導する家庭訪問ケアは,COVID-19のパンデミック中に拡大しました.
- 特にがん患者の間で,自宅での終末期ケアへの大きなシフトが観察されました.
- 標的を絞ったリソースの配分は,健康上の緊急事態中にがん患者のケアをする家庭訪問医師を支援するために不可欠です.
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