REGARDS 研究中≥58 岁成年人的种族和健康社会决定因素在 COVID-19 大流行期间的医疗保健体验。
Health care experiences during the COVID-19 pandemic by race and social determinants of health among adults age ≥ 58 years in the REGARDS study.
机构信息
School of Public Health, University of Alabama at Birmingham, Birmingham, AL, 35294-0022, USA.
Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, USA.
出版信息
BMC Public Health. 2021 Dec 11;21(1):2255. doi: 10.1186/s12889-021-12273-8.
BACKGROUND
Understanding health care experiences during the COVID-19 pandemic may provide insights into patient needs and inform policy. The objective of this study was to describe health care experiences by race and social determinants of health.
METHODS
We conducted a telephone survey (July 6, 2020-September 4, 2021) among 9492 Black and White participants in the longitudinal REasons for Geographic And Racial Differences in Stroke cohort study, age 58-105 years, from the continental United States. Among participants with symptoms of COVID-19, outcomes were: 1. Sought care or advice for the illness; 2. Received a SARS-CoV-2 test for the illness; and 3. Tested positive. Among participants without symptoms of COVID-19, outcomes were: 1. Wanted a test; 2. Wanted and received a test; 3. Did not want but received a test; and 4. Tested positive. We examined these outcomes overall and in subgroups defined by race, household income, marital status, education, area-level poverty, rural residence, Medicaid expansion, public health infrastructure ranking, and residential segregation.
RESULTS
The average age of participants was 76.8 years, 36% were Black, and 57% were female. Among participants with COVID-19 symptoms (n = 697), 74% sought care or advice for the illness, 50% received a SARS-CoV-2 test, and 25% had a positive test (50% of those tested). Among participants without potential COVID-19 symptoms (n = 8795), 29% wanted a SARS-CoV-2 test, 22% wanted and received a test, 8% did not want but received a test, and 1% tested positive; a greater percentage of participants who were Black compared to White wanted (38% vs 23%, p < 0.001) and received tests (30% vs 18%, p < 0.001) and tested positive (1.4% vs 0.8%, p = 0.005).
CONCLUSIONS
In this national study of older US adults, many participants with potential COVID-19 symptoms and asymptomatic participants who desired testing did not receive COVID-19 testing.
背景
了解 COVID-19 大流行期间的医疗保健体验可以洞察患者的需求，并为政策提供信息。本研究的目的是描述按种族和健康社会决定因素划分的医疗保健体验。
方法
我们对来自美国大陆的纵向 REasons for Geographic And Racial Differences in Stroke 队列研究中的 9492 名黑人和白人参与者（年龄 58-105 岁）进行了电话调查（2020 年 7 月 6 日至 2021 年 9 月 4 日）。在有 COVID-19 症状的参与者中，结果为：1. 因疾病寻求治疗或建议；2. 因疾病接受 SARS-CoV-2 检测；3. 检测呈阳性。在无症状 COVID-19 参与者中，结果为：1. 想要检测；2. 希望并接受了检测；3. 不希望但接受了检测；4. 检测呈阳性。我们总体上检查了这些结果，并按种族、家庭收入、婚姻状况、教育程度、地区贫困程度、农村居住、医疗补助扩展、公共卫生基础设施排名和居住隔离等定义的亚组进行了检查。
结果
参与者的平均年龄为 76.8 岁，36%为黑人，57%为女性。在有 COVID-19 症状的参与者中（n=697），74%因疾病寻求治疗或建议，50%接受了 SARS-CoV-2 检测，25%检测结果呈阳性（检测者的 50%）。在无症状 COVID-19 参与者中（n=8795），29%希望进行 SARS-CoV-2 检测，22%希望并接受了检测，8%不希望但接受了检测，1%检测呈阳性；与白人相比，更多的黑人参与者希望（38%比 23%，p<0.001）并接受了检测（30%比 18%，p<0.001），并且检测呈阳性（1.4%比 0.8%，p=0.005）。
结论
在这项针对美国老年成年人的全国性研究中，许多有潜在 COVID-19 症状的参与者和希望接受检测的无症状参与者未接受 COVID-19 检测。
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