医疗保健利用模式的变化和急性脑血管事件的结果 医疗保险队列,2018-2022年
Neuroepidemiology
|January 19, 2026
概括
COVID-19大流行改变了中风患者的医疗保健,增加了门诊访问和死亡率,特别是在社会脆弱地区. 应急和住院护理在中风后减少.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- COVID-19 流行病对脑血管疾病的医疗保健服务产生了重大影响.
- 在脑血管事件后对医疗保健利用率和死亡率的长期影响仍未得到充分研究.
研究的目的:
- 与COVID前相比,分析COVID-19晚期急性脑血管事件后医疗保健利用率和死亡率的变化.
- 根据农村和社会脆弱性,调查这些结果的差异.
主要方法:
- 使用的医疗保险服务费用和医疗保险优势数据从2018-2022年.
- 在COVID前 (2018-2019) 和COVID后期 (2021-2022) 期间,使用Poisson-lognormal回归来比较医疗保健利用率 (门诊,ED,住院) 和死亡率.
- 根据年龄,性别,种族进行调整,并根据农村和社会脆弱性指数 (SVI) 四分位数分析结果.
主要成果:
- 在COVID后期,门诊访问率增加 (IRR=1.14) ,而急诊室访问 (IRR=0.92) 和住院 (IRR=0.94) 在COVID后期减少.
- 在COVID后期,死亡率显著更高 (IRR=1.24).
- 死亡率的增加在社会弱势地区 (SVI四分位数3和4) 最为明显.
结论:
- 与COVID前相比,在COVID后期经历急性脑血管事件的Medicare受益人面临着医疗保健利用率的改变和死亡率的增加.
- 在COVID后期,社会弱势群体在中风后死亡率上升最为显著.
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