在COVID-19大流行之前和期间,可避免住院的趋势:使用来自中国北京的行政数据进行多项跨部门研究
Xiangzhen Wang1, Yin Chen2, Yuqi Ta3
1School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing, 100191, China, 86 15120079272.
JMIR public health and surveillance
|July 3, 2025
概括
北京的可避免住院病例 (AHs) 在大流行前上升,但在COVID-19期间下降. 像AHs这样的初级保健质量指标需要仔细解释,考虑到流行病影响和社会经济因素.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生政策 公共卫生政策
- 流行病学 流行病学
背景情况:
- 在高收入国家,可避免的住院病例 (AHs) 被用作初级保健质量指标,但在中国等低收入和中等收入国家没有充分研究.
- 关于COVID-19大流行之前和期间的AH趋势的研究有限,在这种情况下,它们作为质量指标的有效性受到争论.
研究的目的:
- 分析2016-2019年 (大流行前) 和2020-2021年 (大流行) 中北京,中国的 AHs 的趋势.
- 确定与AH率相关的因素,包括COVID-19爆发,医疗保健资源和社会经济特征.
主要方法:
- 利用了2016年至2021年北京居民医院出院数据.
- 根据性别和年龄标准化的AH率计算,调整为人口结构.
- 使用回归分析来检查AH率与COVID-19病例,医疗保健资源和社会经济因素等解释变量之间的关联.
主要成果:
- 从2016年到2019年,AH率增加,然后在2020年大幅下降,并在2021年部分反弹,仍然低于大流行前的水平.
- 确诊的COVID-19病例与较低的AH率有关.
- 较高的初级医生密度与较低的AH率相关,以及人口结构,经济发展和人口统计学变量.
结论:
- 北京的疫情前的高血压率很高,这表明三级医疗过度使用和需要以初级保健为重点的改革.
- 流行病冲击和社会经济因素影响HA率,需要仔细解释HA作为初级保健绩效指标.
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