JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, China.
Department of Urban Planning and Design, The Social Infrastructure for Equity and Wellbeing (SIEW) Lab, The University of Hong Kong, Pokfulam Road, Hong Kong, China; The University of Hong Kong Shenzhen Institute of Research and Innovation, Shenzhen, China.
Health Place. 2020 Nov;66:102465. doi: 10.1016/j.healthplace.2020.102465. Epub 2020 Oct 17.
Early diagnosis is important to control COVID-19 outbreaks. This study aimed to assess how individual and area socioeconomic position and geographical accessibility to healthcare services were associated with the time to diagnosis among symptomatic COVID-19 patients in Hong Kong. Multivariable generalized linear regression was used to estimate the associations while adjusting for sociodemographic characteristics and case classification. This study found living in public rental housing and living in an area with low education were associated with longer time to diagnosis in the first wave of infections. Specifically, the risk of delayed diagnosis for public rental housing residents was mitigated by the higher density of public clinics/hospitals but was slightly increased by the higher density of private medical practitioners nearby. No such relations were found in the second wave of infections when the surveillance measures were enhanced. Given the grave impact of pandemics around the world, our findings call on taking inequalities into account when public health policies are being devised.
早期诊断对于控制 COVID-19 疫情至关重要。本研究旨在评估个体和地区社会经济地位以及获得医疗保健服务的地理可达性与香港有症状 COVID-19 患者的诊断时间之间的关系。多变量广义线性回归用于估计关联,同时调整社会人口统计学特征和病例分类。本研究发现,在第一波感染中,居住在公屋和居住在教育程度较低的地区与诊断时间延长有关。具体来说,公共诊所/医院密度较高减轻了公屋居民延迟诊断的风险,但附近私人执业医生密度较高则略微增加了这种风险。在加强监测措施的第二波感染中,没有发现这种关系。鉴于世界各地大流行的严重影响,我们的研究结果呼吁在制定公共卫生政策时考虑不平等问题。