Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114. Email:
Am J Manag Care. 2020 Aug;26(8):327-328. doi: 10.37765/ajmc.2020.43837.
To determine whether patients are deferring necessary care for urgent conditions during the coronavirus disease 2019 (COVID-19) pandemic and, if so, to what extent.
Cross-sectional study.
Using billing data from 8 acute care hospitals, we identified 9 principal medical diagnoses from International Classification of Diseases, Tenth Revision codes across 4 medical specialties (cardiology, gastroenterology, neurology, and urology). In addition, we defined a combined obstetrical falsification end point. We compared daily admission rates during the pandemic period (3/1/2020-4/30/2020) with the same dates in 2019 (3/1/2019-4/30/2019). As a reference, we also compared a prepandemic period in the same years (1/1/2019-2/28/2019 and 1/1/2020-2/29/2020). We compared admission rates between years using t tests.
There were 3219 admissions for the conditions of interest during the study period in 2019 and 2661 in 2020. There was no difference in prepandemic daily admission rates in 2020 compared with 2019 (29.04 vs 27.63 admissions per day; -4.9%; P = .50). During the pandemic period, there was a 33.7% decrease in admission rates for all conditions combined in 2020 compared with 2019 (24.68 vs 16.37; -33.7%; P = .03). By specialty, the combined gastroenterology (10.22 vs 7.20; -29.6%; P = .02) and cardiovascular (2.34 vs 1.29; -44.7%; P = .05) end points demonstrated reduction in daily admission rates.
Daily admission rates during the COVID-19 pandemic were lower for these acute medical conditions. Public awareness campaigns are urgently needed to reassure the public about the safety of presenting for care.
确定在 2019 冠状病毒病(COVID-19)大流行期间,患者是否会推迟紧急情况下的必要治疗,如果是,推迟的程度如何。
横断面研究。
我们使用 8 家急症医院的计费数据,从 4 个医学专业(心脏病学、胃肠病学、神经病学和泌尿科)的国际疾病分类第十版代码中确定了 9 个主要的医疗诊断。此外,我们还定义了一个联合产科伪造终点。我们比较了大流行期间(2020 年 3 月 1 日至 4 月 30 日)与 2019 年同期(2019 年 3 月 1 日至 4 月 30 日)的每日入院率。作为参考,我们还比较了同年的大流行前时期(2019 年 1 月 1 日至 2 月 28 日和 2020 年 1 月 1 日至 2 月 29 日)。我们使用 t 检验比较了年度入院率。
在 2019 年的研究期间,有 3219 例符合条件的入院治疗,而 2020 年有 2661 例。与 2019 年相比,2020 年大流行前每日入院率没有差异(29.04 与 27.63 入院/天;-4.9%;P=.50)。在大流行期间,与 2019 年相比,2020 年所有疾病的综合入院率下降了 33.7%(24.68 与 16.37;-33.7%;P=.03)。按专业划分,综合胃肠病学(10.22 与 7.20;-29.6%;P=.02)和心血管(2.34 与 1.29;-44.7%;P=.05)终点的每日入院率均有所下降。
在 COVID-19 大流行期间,这些急性医疗条件的每日入院率较低。迫切需要开展公众宣传活动,让公众放心前来就诊是安全的。