州退伍军人住宅中的COVID-19感染和死亡率:一个多层次的方法
Stephen Frochen1, W Neil Steers1, Tamar Wyte-Lake1
1Center for the Study of Healthcare Innovation, Implementation, and Policy (CSHIIP), VA Greater Los Angeles Healthcare System, North Hills, CA, USA; Veterans Emergency Management Evaluation Center (VEMEC), VA Greater Los Angeles Healthcare System, North Hills, CA, USA.
Journal of the American Medical Directors Association
|December 11, 2023
概括
州退伍军人住宅 (SVHs) 的COVID-19感染人数较少,但死亡人数比社区养老院 (CNHs) 更多. 地理分析显示,这些设施在美国各地区的感染和死亡率模式不同.
科学领域:
- 老年学是指老年学的学科.
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 在COVID-19期间,州退伍军人住宅 (SVH) 面临着针对感染控制和死亡率的审查.
- 与社区养老院 (CNH) 相比,对SVH差异的研究有限.
- 养老院感染率和死亡率的地理趋势仍未得到充分研究.
研究的目的:
- 为了比较SVHs和CNHs之间的COVID-19感染和死亡率.
- 分析美国老年院感染率和死亡率的地理分布.
- 确定设施级结果中的潜在区域差异.
主要方法:
- 美国熟练护理机构的回顾性全国性队列研究 (2020年5月-2022年7月).
- 多级负双项回归来模型COVID-19感染率和死亡率.
- 纳入了县级随机效应,以调整地理差异.
主要成果:
- 与CNH相比,SVH的感染率降低了18%,但死亡率高出25%.
- 高感染率集中在中西部,大西洋和南部州.
- 高死亡率在带,中西部和南部州普遍存在,西部/中部州的死亡率较低.
结论:
- 与CNH相比,SVH的感染率较低,但死亡风险更高.
- 患有SVH的县有较少的极端感染和死亡率,尽管个体设施死亡风险更高.
- 需要对设施层面的差异 (例如人口统计) 和细粒度的地理数据进行进一步的研究,以了解SVH风险.
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