使用空间层次模型的Covid-19医院死亡率:用74,994个注册表进行队列设计
Francisco Chiaravalloti Neto1, Patricia Marques Moralejo Bermudi1, Breno Souza de Aguiar2
1Universidade de São Paulo. Faculdade de Saude Publica. São Paulo, SP, Brasil.
Revista de saude publica
|May 31, 2023
概括
地理收入不平等显著影响圣保罗的COVID-19医院死亡风险. 减少社会经济差距对于控制死亡率和改善公共卫生结果至关重要.
科学领域:
- 流行病学 流行病学
- 公共卫生 公共卫生
- 空间分析 空间分析
背景情况:
- COVID-19对全球健康构成重大威胁,死亡率因多种因素而变化.
- 了解个人和上下文决定因素的相互作用对于有效的公共卫生干预至关重要.
- 疾病结果的空间依赖凸显了地理信息分析的必要性.
研究的目的:
- 为了检查COVID-19医院死亡率和巴西圣保罗的风险因素之间的关系.
- 将上下文,个人和空间因素纳入死亡风险分析.
- 确定COVID-19医院死亡率空间差异的关键驱动因素.
主要方法:
- 采用了一个空间层次的回顾性队列研究设计.
- 使用了住院患者及其居住地理单元的二次数据.
- 用伯努利分布和集成嵌套拉普拉斯近似的贝叶斯模型来分析死亡率,考虑人口统计,远端,中端和近端共变量.
主要成果:
- 人均收入成为抗击COVID-19医院死亡率的重要保护因素 (OR:0.76).
- 地理收入不平等被确定为死亡风险空间差异的主要驱动因素.
- 其他重大风险因素包括男性性别,晚年,并发症,通风使用,公共卫生保健治疗和症状发病时间.
结论:
- 除了性别和年龄之外,地理收入不平等是COVID-19医院死亡风险空间变化的主要决定因素.
- 旨在减少社会经济不平等和预防感染的公共政策至关重要.
- 建议针对人均收入较低的地区进行有针对性的干预措施,以减轻COVID-19医院死亡率.
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