Zunzunegui Maria Victoria, Béland François, García López Fernando J
École de Santé Publique, Université de Montréal, Montréal, QC H3N 1X9, Canada.
National Epidemiology Centre, Instituto de Salud Carlos III, 28929 Madrid, Spain.
Epidemiologia (Basel). 2023 Jun 6;4(2):176-187. doi: 10.3390/epidemiologia4020019.
In March 2020, a ministerial directive issued by the Government of the Community of Madrid (CoM) in Spain included disability-based exclusion criteria and recommendations against hospital referral of patients with respiratory conditions living in long-term care homes (LTCHs). Our objective was to assess whether the hospitalization mortality ratio (HMR) is greater than unity, as would be expected had the more severe COVID-19 cases been hospitalized. Thirteen research publications were identified in this systematic review of mortality by place of death of COVID-19-diagnosed LTCH residents in Spain. In the two CoM studies, the HMRs were 0.9 (95%CI 0.8;1.1) and 0.7 (95%CI 0.5;0.9), respectively. Outside of the CoM, in 9 out of 11 studies, the reported HMRs were between 1.7 and 5, with lower 95% CI limits over one. Evaluation of the disability-based triage of LTCH residents during March-April 2020 in public hospitals in the CoM should be conducted.
2020年3月，西班牙马德里自治区政府发布的一项部级指令纳入了基于残疾的排除标准，并建议不要将居住在长期护理机构（LTCH）中的呼吸道疾病患者转诊至医院。我们的目标是评估住院死亡率（HMR）是否大于1，这是如果将更严重的新冠肺炎病例收治入院时所预期的情况。在这项对西班牙新冠肺炎确诊LTCH居民按死亡地点进行死亡率的系统评价中，共识别出13篇研究出版物。在马德里自治区的两项研究中，HMR分别为0.9（95%CI 0.8；1.1）和0.7（95%CI 0.5；0.9）。在马德里自治区以外，11项研究中有9项报告的HMR在1.7至5之间，95%CI下限超过1。应对2020年3月至4月期间马德里自治区公立医院对LTCH居民基于残疾的分诊情况进行评估。
