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新冠疫情对中国宁波医院就诊的影响:一项中断时间序列分析。

Effect of COVID-19 on hospital visits in Ningbo, China: an interrupted time-series analysis.

机构信息

Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, 866 Yuhangtang Road, Hangzhou, Zhejiang 310058, China.

Department of Chronic Disease and Health Promotion, Yinzhou District Center for Disease Control and Prevention, 1221 Xueshi Road, Ningbo, Zhejiang 315100, China.

出版信息

Int J Qual Health Care. 2021 May 7;33(2). doi: 10.1093/intqhc/mzab078.

Abstract

OBJECTIVE

Unprecedented rigorous public health measures were implemented during the coronavirus disease 2019 (COVID-19) epidemic, but it is still unclear how the intervention influenced hospital visits for different types of diseases. We aimed to evaluate the impact of the intervention on hospital visits in Yinzhou District, Ningbo, Zhejiang province, China.

METHODS

We conducted an interrupted time-series analysis from 1 January 2017 to 6 September 2020 based on the Yinzhou Health Information System in Ningbo, Zhejiang province. The beginning of the intervention was on 23 January 2020, and thus, there were 160 weeks before the intervention and 32 weeks after the implementation of the intervention. Level changes between expected and observed hospital visits in the post-intervention period were estimated using quasi-Poisson regression models.

RESULTS

Compared with the expected level, there was an estimated decrease of -22.60% (95% confidence interval (CI): -27.53%, -17.36%) in the observed total hospital visits following the intervention. Observed hospital visits for diseases of the respiratory system were found to be decreased dramatically (-62.25%; 95% CI: -65.62%, -58.60%). However, observed hospital visits for certain diseases were estimated to be increased, including diseases of the nervous system (+11.17%; 95% CI: +3.21%, +19.74%); diseases of pregnancy, childbirth and the puerperium (+27.01%; 95% CI: +17.89%, +36.85%); certain conditions originating in the perinatal period (+45.05%; 95% CI: +30.24%, +61.56%); and congenital malformation deformations and chromosomal abnormalities (+35.50%; 95% CI: +21.24%, +51.45%).

CONCLUSIONS

Our findings provided scientific evidence that cause-specific hospital visits evolve differently following the intervention during the COVID-19 epidemic.

摘要

目的

在 2019 年冠状病毒病(COVID-19)疫情期间,实施了前所未有的严格公共卫生措施,但干预措施对不同类型疾病的就诊影响仍不清楚。本研究旨在评估干预措施对中国浙江省宁波市鄞州区就诊的影响。

方法

我们基于浙江省宁波市鄞州区卫生信息系统,对 2017 年 1 月 1 日至 2020 年 9 月 6 日进行了一项中断时间序列分析。干预开始于 2020 年 1 月 23 日,因此,干预前有 160 周,干预后有 32 周。使用拟泊松回归模型估计干预后预期和观察到的就诊次数之间的水平变化。

结果

与预期水平相比,干预后观察到的总就诊次数估计减少了-22.60%(95%置信区间:-27.53%,-17.36%)。观察到呼吸系统疾病的就诊次数明显减少(-62.25%;95%置信区间:-65.62%,-58.60%)。然而,某些疾病的观察就诊次数估计有所增加,包括神经系统疾病(+11.17%;95%置信区间:+3.21%,+19.74%);妊娠、分娩和产褥期疾病(+27.01%;95%置信区间:+17.89%,+36.85%);某些围生期来源的疾病(+45.05%;95%置信区间:+30.24%,+61.56%);以及先天性畸形、变形和染色体异常(+35.50%;95%置信区间:+21.24%,+51.45%)。

结论

本研究结果提供了科学证据,表明 COVID-19 疫情期间,干预措施后特定病因的就诊次数演变不同。

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