Department of Internal Medicine, NYC Health + Hospitals/Metropolitan, NY 10029, USA; Department of Internal Medicine, Yale New Haven Health Bridgeport Hospital, CT 06610, USA.
Department of Internal Medicine, NYC Health + Hospitals/Metropolitan, NY 10029, USA.
Heart Lung. 2022 Sep-Oct;55:140-145. doi: 10.1016/j.hrtlng.2022.04.017. Epub 2022 May 16.
The Social Vulnerability Index (SVI) is a publicly available dataset to identify communities in greatest need of resources.
To examine the utility of using the county-level SVI as predictors of asthma-related outcomes.
We used the American Community Survey-derived SVI and the National Environmental Public Health Tracking Network - Query Tool to retrieve data for all counties with available SVI data and at least one matched outcome of interest. Then, we tested SVI as a predictor for emergency department visits (EDV) and hospitalizations, with investigating disparities in primary care physician (PCP) density and emergency department physicians (EDP) density. Linear and logistic regression models were used.
Compared to counties of the lowest SVI quartile, counties of mid-low, mid-high, and highest SVI quartiles had 1%, 4%, and 5% higher odds of asthma-related EDV per 10,000 population, respectively, and 4%, 21%, and 24% higher odds of asthma-related hospitalization per 10,000 population, respectively. Moreover, the data showed an apparent resources mismatch between the EDP densities per 10,000 populations and the SVI quartiles, and the effect of the county level SVI on the asthma-related EDV and hospitalization is not strongly affected by PCP or EDP densities.
The counties with the highest SVI -and the most vulnerable to asthma hazards- have a lower coverage of PCP and EDP. Interventions directed to address persistent social vulnerability would offer the opportunity of primary prevention with less exhaustion for the medical resources.
社会脆弱性指数（SVI）是一个公开的数据集，用于确定最需要资源的社区。
检验使用县级 SVI 作为预测哮喘相关结局的工具的效用。
我们使用了美国社区调查衍生的 SVI 和国家环境公共卫生跟踪网络-查询工具，检索了所有具有可用 SVI 数据和至少一个匹配的感兴趣结局的县的数据。然后，我们测试了 SVI 作为急诊就诊（EDV）和住院的预测因子，同时调查了初级保健医生（PCP）密度和急诊医生（EDP）密度的差异。使用了线性和逻辑回归模型。
与 SVI 最低四分位数的县相比，SVI 中低、中高和最高四分位数的县的哮喘相关 EDV 每 10000 人分别高出 1%、4%和 5%，哮喘相关住院每 10000 人分别高出 4%、21%和 24%。此外，数据显示 EDP 密度与 SVI 四分位数之间存在明显的资源错配，而且 SVI 对哮喘相关 EDV 和住院的影响不受 PCP 或 EDP 密度的强烈影响。
SVI 最高的县（即最易受哮喘危害影响的县）的 PCP 和 EDP 覆盖率较低。针对社会脆弱性的干预措施提供了利用初级预防减少医疗资源消耗的机会。
