Portuondo-Jiménez Janire, Gascón María, García Julia, Legarreta María-José, Villanueva Ane, Larrea Nere, García-Gutiérrez Susana, Munitiz Endika, Quintana José M
Osakidetza Servicio Vasco de Salud, Subdirección de Coordinación de Atención Primaria, Vitoria-Gasteiz, España; Instituto de Investigación Sanitaria Biocruces Bizkaia, Grupo de Investigación en Ciencias de la Diseminación e Implementación en Servicios de Salud, Barakaldo, Bizkaia, España; Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), España.
Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), España; Osakidetza Servicio Vasco de Salud, Hospital Universitario Galdakao-Usansolo, Unidad de Investigación, Galdakao, Bizkaia, España; Red de Investigación de Servicios de Salud en Enfermedades Crónicas (REDISSEC), España; Instituto Kronikgune de Investigación en Servicios Sanitarios, Barakaldo, Bizkaia, España.
Gac Sanit. 2023 Apr 5;37:102301. doi: 10.1016/j.gaceta.2023.102301. eCollection 2023.
To see the relationship between the population deprivation index and the use of the health services, adverse evolution and mortality during the COVID-19 pandemic.
Retrospective cohort study of patients with SARS-CoV-2 infection from March 1, 2020 to January 9, 2022. The data collected included sociodemographic data, comorbidities and prescribed baseline treatments, other baseline data and the deprivation index, estimated by census section. Multivariable multilevel logistic regression models were performed for each outcome variable: death, poor outcome (defined as death or intensive care unit), hospital admission, and emergency room visits.
The cohort consists of 371,237 people with SARS-CoV-2 infection. In the multivariable models, a higher risk of death or poor evolution or hospital admission or emergency room visit was observed within the quintiles with the greatest deprivation compared to the quintile with the least. For the risk of being hospitalized or going to the emergency room, there were differences between most quintiles. It has also been observed that these differences occurred in the first and third periods of the pandemic for mortality and poor outcome, and in all due for the risk of being admitted or going to the emergency room.
The groups with the highest level of deprivation have had worse outcomes compared to the groups with lower deprivation rates. It is necessary to carry out interventions that minimize these inequalities.
研究新冠疫情期间人口贫困指数与医疗服务利用、不良病情发展及死亡率之间的关系。
对2020年3月1日至2022年1月9日期间感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的患者进行回顾性队列研究。收集的数据包括社会人口统计学数据、合并症及规定的基线治疗、其他基线数据以及按普查区估算的贫困指数。针对每个结局变量（死亡、不良结局[定义为死亡或入住重症监护病房]、住院和急诊就诊）进行多变量多水平逻辑回归模型分析。
该队列由371,237名感染SARS-CoV-2的患者组成。在多变量模型中，与贫困程度最低的五分位数相比，贫困程度最高的五分位数内观察到死亡、不良病情发展、住院或急诊就诊的风险更高。对于住院或前往急诊室的风险，大多数五分位数之间存在差异。还观察到，这些差异在疫情的第一和第三阶段出现于死亡率和不良结局方面，而在住院或前往急诊室风险方面则在所有阶段都存在。
与贫困率较低的群体相比，贫困程度最高的群体结局更差。有必要开展干预措施以尽量减少这些不平等现象。
