Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Seoul, Korea.
Epidemiol Health. 2021;43:e2021061. doi: 10.4178/epih.e2021061. Epub 2021 Sep 8.
During the coronavirus disease 2019 (COVID-19) pandemic, crude incidence and mortality rates have been widely reported; however, age-standardized rates are more suitable for comparisons. In this study, we estimated and compared the age-standardized incidence, mortality, and case fatality rates (CFRs) among countries and investigated the relationship between these rates and factors associated with healthcare resources: gross domestic product per capita, number of hospital beds per population, and number of doctors per population.
The incidence, mortality, and CFRs of 79 countries were age-standardized using the World Health Organization standard population. The rates for persons 60 years or older were also calculated. The relationships among the rates were analysed using trend lines and coefficients of determination (R2). Pearson correlation coefficients between the rates and the healthcare resource-related factors were calculated.
The countries with the highest age-standardized incidence, mortality, and CFRs were Czechia (14,253 cases/100,000), Mexico (182 deaths/100,000), and Mexico (6.7%), respectively. The R2 between the incidence and mortality rates was 0.852 for all ages and 0.945 for those 60 years or older. The healthcare resources-related factors were associated positively with incidence rates and negatively with CFRs, with weaker correlations among the elderly.
Compared to age-standardized rates, crude rates showed greater variation among countries. Medical resources may be important in preventing COVID-19-related deaths; however, considering the small variation in fatality among the elderly, preventive measures such as vaccination are more important, especially for the elderly population, to minimize the mortality rates.
在 2019 年冠状病毒病（COVID-19）大流行期间，粗发病率和死亡率已被广泛报道；然而，标化发病率更适合进行比较。本研究旨在估计和比较各国的标化发病率、死亡率和病死率（CFR），并探讨这些比率与与医疗保健资源相关的因素之间的关系：人均国内生产总值、每人口的病床数和每人口的医生数。
使用世界卫生组织标准人口对 79 个国家的发病率、死亡率和 CFR 进行标化。还计算了 60 岁及以上人群的比率。使用趋势线和确定系数（R2）分析比率之间的关系。计算比率与医疗保健资源相关因素之间的 Pearson 相关系数。
标化发病率、死亡率和 CFR 最高的国家分别为捷克（14253 例/100000）、墨西哥（182 例/100000）和墨西哥（6.7%）。所有年龄组的发病率和死亡率之间的 R2 为 0.852，60 岁及以上人群的 R2 为 0.945。医疗保健资源相关因素与发病率呈正相关，与病死率呈负相关，老年人之间的相关性较弱。
与标化率相比，粗率在国家之间的差异更大。医疗资源可能对预防 COVID-19 相关死亡很重要；然而，考虑到老年人病死率的微小差异，预防措施（如接种疫苗）更为重要，特别是对于老年人群，以最大程度降低死亡率。
