德克萨斯州无保险患者的慈善覆盖和COVID-19死亡率降低:一项回顾性队列研究
Anisha P Ganguly1, John T Battaile2,3, Michael Harms2
1Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
PloS one
|September 10, 2025
概括
县政府资助的慈善保险 (CFCC) 显著降低了未保险的COVID-19患者的死亡率. 这一发现表明,扩大CFCC可以改善弱势群体的健康结果.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 流行病学 流行病学
背景情况:
- 健康的社会驱动因素和有限的护理机会有助于COVID-19的差异.
- 没有保险的人群在获得医疗保健和医疗保健结果方面面临重大挑战.
研究的目的:
- 调查县政府资助的慈善保险 (CFCC) 与COVID-19住院的无保险患者的死亡率之间的关联.
- 评估CFCC对高无保险人口中COVID-19结果的影响.
主要方法:
- 使用德克萨斯州达拉斯县安全网卫生系统的电子健康记录 (EHR) 进行的回顾性队列研究.
- 在CFCC接收者和因COVID-19住院的无保险患者之间,死亡率和临床结果的比较 (2020年6月 - 2021年12月).
- 考克斯的比例危险模型被用于调整人口因素和并发症.
主要成果:
- 在2047名没有保险的患者中,47.0%患有CFCC. 与自付患者相比,CFCC患者经过调整后的180天死亡率 (aHR 0.61) 降低.
- CFCC与较低的90天死亡率 (OR 0.64) 和减少早期输管治疗的需要 (OR 0.46) 有关.
- 用CFCC治疗 (NNT) 预防一例死亡的必要人数为30.4,与标准COVID-19药物相比.
结论:
- 县资助的慈善保险 (CFCC) 与住院治疗COVID-19的未保险人群的死亡率显著降低有关.
- 在降低死亡率方面,CFCC的有效性与已有的COVID-19医学治疗方法相美.
- 扩大CFCC计划是一个可行的策略,以减轻COVID-19的差异,并改善无保险患者的结果.
相关概念视频
Preventive Healthcare Services
1.9K
Preventive healthcare services keep people healthy via frequent check-ups, screening, and counseling. They primarily aid in disease prevention rather than treating an acute or chronic illness. Preventive treatment also keeps individuals productive and energetic, allowing them to work well into their retirement years. Examples of preventive care services include:
1.9K
Bias in Epidemiological Studies
1.3K
Biases can arise at various stages of research, from study design and data collection to analysis and interpretation. Recognizing and addressing these biases is essential to ensure the validity and reliability of epidemiological findings.Broadly speaking, biases in epidemiology fall into three main categories: selection bias, information bias, and confounding. A more detailed description of possible biases is:
1.3K
Actuarial Approach
290
The actuarial approach, a statistical method originally developed for life insurance risk assessment, is widely used to calculate survival rates in clinical and population studies. This method accounts for participants lost to follow-up or those who die from causes unrelated to the study, ensuring a more accurate representation of survival probabilities.
Consider the example of a high-risk surgical procedure with significant early-stage mortality. A two-year clinical study is conducted,...
Consider the example of a high-risk surgical procedure with significant early-stage mortality. A two-year clinical study is conducted,...
290
Cancer Survival Analysis
650
Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...
650
Relative Risk
2.0K
Relative risk (RR) is a statistical measure commonly used in epidemiology to compare the likelihood of a particular event occurring between two groups. This metric is important for evaluating the relationship between exposure to a specific risk factor and the probability of a particular outcome. It plays a crucial role in medical research, public health studies, and risk assessment. Relative risk quantifies how much more (or less) likely an event is to occur in an exposed group compared to an...
2.0K
Methods Of Healthcare Delivery System
4.0K
At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
4.0K

