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医疗和社会因素对 COVID-19 封锁期间以色列老年人医疗服务利用的影响。

Medical and social factors influencing the utilization of healthcare services among older adults in Israel during the COVID-19 lockdown.

机构信息

Department of Health Systems Management, School of Health Sciences, Ariel University, Ariel, Israel.

Natali, Ramat Gan, Israel.

出版信息

Front Public Health. 2023 Sep 27;11:1218507. doi: 10.3389/fpubh.2023.1218507. eCollection 2023.

Abstract

BACKGROUND

The corona virus disease 2019 (COVID-19) pandemic significantly impacted older adults. However, most older communities focused on the medical issues. The aims of this study were to identify the medical and social factors linked with the usage of medical services during the COVID-19 lockdown in Israel.

METHODS

The study was conducted Over two periods of time from February to April in 2019 (P1), before the COVID-19 and from February to April in 2020 (P2), during the first lockdown. The study was conducted on people aged 65 and older in Israel. The variable statistics were analyzed using frequency tabulation, cross-tabulation frequencies, and t-tests. Two hierarchical logistic regressions were conducted over four steps for each period.

RESULTS

The participants (n = 102,303) comprised 64.5% female (65,946) and 35.5% male (36,357) (mean age 80.5, SD- 7.46). It was found that participants who had not subscribed to the supportive community services were 7.47 times more likely to access medical services in P1 and 12.417 times more likely to access medical services during the lockdown. This variable was also found to be a strong predictor in the final model. The most significant variable for predicting the participants' needs during P2 was their previous needs in P1. Other social variables were living in assisted living home and living in community settlements. The presence of 12 diseases in this study did not predict service demand.

CONCLUSION

Community support reduces medical service demands during disasters and provides services for older adults. During pandemics, however, social services need to be expanded and made more easily accessible to older adults.

摘要

背景

2019 年冠状病毒病(COVID-19)大流行对老年人影响重大。然而,大多数老年社区主要关注医疗问题。本研究旨在确定与 COVID-19 封锁期间以色列医疗服务使用相关的医疗和社会因素。

方法

本研究分两个时间段进行,分别为 2019 年 2 月至 4 月(P1),即 COVID-19 之前,以及 2020 年 2 月至 4 月(P2),即第一次封锁期间。研究对象为以色列 65 岁及以上的人群。使用频数制表、交叉表频数和 t 检验对变量进行统计分析。对每个时期进行了两个四步分层逻辑回归。

结果

参与者(n=102303)中 64.5%为女性(65946 人),35.5%为男性(36357 人)(平均年龄 80.5,标准差 7.46)。结果发现,在 P1 未订阅支持性社区服务的参与者更有可能在 P1 期间和封锁期间获得医疗服务,可能性分别是订阅者的 7.47 倍和 12.417 倍。该变量也是最终模型中的一个强有力的预测因子。预测 P2 期间参与者需求的最重要变量是其在 P1 期间的先前需求。其他社会变量是居住在辅助生活之家和居住在社区定居点。本研究中的 12 种疾病并不预示着服务需求。

结论

社区支持可减少灾害期间对医疗服务的需求,并为老年人提供服务。然而,在大流行期间,需要扩大社会服务范围,并使其更容易为老年人所获得。

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