Ronan Matthew V, Mukamal Kenneth J, Ganatra Rahul B
Veterans Affairs Boston Healthcare System, West Roxbury, Massachusetts.
Harvard Medical School, Boston, Massachusetts.
Fed Pract. 2023 Aug;40(8):242-247g. doi: 10.12788/fp.0404. Epub 2023 Aug 18.
The effect of initial COVID-19 pandemic-associated lockdowns on alcohol-related hospitalizations remains uncertain. This study compares alcohol-related hospitalizations at a US Department of Veterans Affairs (VA) system in Massachusetts before, during, and after the initial COVID-19 lockdown.
This study is an interrupted time-series analysis at the VA Boston Healthcare System. Participants included all patients hospitalized on the medical, psychiatry, and neurology services at VA Boston Healthcare System from January 1, 2017, to December 31, 2020, excluding those under observation status. The period January 1, 2017, to March 9, 2020, was defined as prelockdown (the reference group); March 10, 2020, to May 18, 2020, was lockdown; and May 19, 2020, to December 31, 2020, was postlockdown. Alcohol-related hospitalizations were determined using primary diagnosis codes.
We identified 27,508 hospitalizations during the study periods. There were 72 alcohol-related hospitalizations per 100,000 patient-months during the prelockdown period, 10 per 100,000 patient-months during the lockdown, and 46 per 100,000 patient-months in the postlockdown period. Compared with the prelockdown period, the adjusted rate ratio for daily alcohol-related hospitalizations during lockdown was 0.20 (95% CI, 0.10-0.39) vs 0.72 (95% CI, 0.57-0.92) after the lockdown. A similar pattern was observed for all-cause hospitalizations.
Our results suggest that COVID-19 pandemic lockdown measures were associated with fewer alcohol-related hospitalizations. Proactive outreach for vulnerable populations during lockdowns is needed.
2019冠状病毒病(COVID-19)大流行初期相关封锁措施对酒精相关住院治疗的影响仍不确定。本研究比较了美国马萨诸塞州退伍军人事务部(VA)系统在COVID-19首次封锁之前、期间和之后与酒精相关的住院情况。
本研究是对VA波士顿医疗系统进行的中断时间序列分析。参与者包括2017年1月1日至2020年12月31日在VA波士顿医疗系统接受内科、精神科和神经科服务住院治疗的所有患者,但不包括处于观察状态的患者。2017年1月1日至2020年3月9日期间定义为封锁前(参照组);2020年3月10日至2020年5月18日为封锁期;2020年5月19日至2020年12月31日为封锁后。使用主要诊断编码确定与酒精相关的住院情况。
我们在研究期间确定了27508例住院病例。封锁前每100000患者月有72例与酒精相关的住院病例,封锁期间每100000患者月有10例,封锁后每100000患者月有46例。与封锁前相比,封锁期间每日酒精相关住院治疗的调整率比为0.20(95%CI,0.10 - 0.39),而封锁后为0.72(95%CI,0.57 - 0.92)。在全因住院方面观察到类似模式。
我们的结果表明,COVID-19大流行封锁措施与酒精相关住院病例减少有关。在封锁期间需要对弱势群体进行积极的 outreach。 (注:outreach在文中无明确对应中文,可能是指某种主动接触、 outreach 行动等,此处保留英文。)