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大流行冲击对 10 个国家中老年未满足医疗需求的影响。

Impact of a pandemic shock on unmet medical needs of middle-aged and older adults in 10 countries.

机构信息

Institute of Population Research, Peking University, Beijing, China

APEC Health Science Academy, Peking University, Beijing, China.

出版信息

BMJ Health Care Inform. 2024 Apr 8;31(1):e100865. doi: 10.1136/bmjhci-2023-100865.

Abstract

OBJECTIVE

The objective is to explore the impact of the pandemic shock on the unmet medical needs of middle-aged and older adults worldwide.

METHODS

The COVID-19 pandemic starting in 2020 was used as a quasiexperiment. Exposure to the pandemic was defined based on an individual's context within the global pandemic. Data were obtained from the Integrated Values Surveys. A total of 11 932 middle-aged and older adults aged 45 years and above from 10 countries where the surveys conducted two times during 2011 and 2022 were analysed. We used logistic regression models with the difference-in-difference method to estimate the impact of pandemic exposure on unmet medical needs by comparing differences before and after the pandemic across areas with varying degrees of severity.

RESULTS

Among the 11 932 middle-aged and older adults, 3647 reported unmet medical needs, with a pooled unmet rate of 30.56% (95% CI: 29.74% to 31.40%). The pandemic significantly increased the risk of unmet medical needs among middle-aged and older adults (OR: 2.33, 95% CI: 1.94 to 2.79). The deleterious effect of the pandemic on unmet medical needs was prevalent among middle-aged adults (2.53, 2.00 to 3.20) and older adults (2.00, 1.48 to 2.69), as well as among men (2.24, 1.74 to 2.90) and women (2.34, 1.82 to 3.03). The results remained robust in a series of sensitivity analyses.

CONCLUSION

These findings suggest that efforts should be made by policymakers and healthcare professionals to balance healthcare resources to adequately address the comprehensive healthcare demands of individuals regarding multiple health issues, taking into account the challenges posed by pandemics.

摘要

目的

探讨大流行冲击对全球中老年人群未满足的医疗需求的影响。

方法

本研究将 2020 年开始的 COVID-19 大流行作为准实验。根据个体在全球大流行中的背景定义接触大流行。数据来自综合价值观调查。分析了来自 10 个国家的 11932 名 45 岁及以上的中老年成年人的数据,这些国家在 2011 年和 2022 年期间进行了两次调查。我们使用具有差异-差异法的逻辑回归模型,通过比较不同严重程度地区大流行前后的差异,来估计大流行暴露对未满足的医疗需求的影响。

结果

在 11932 名中老年成年人中,有 3647 人报告未满足医疗需求,总体未满足率为 30.56%(95%可信区间:29.74%至 31.40%)。大流行显著增加了中老年成年人未满足医疗需求的风险(OR:2.33,95%可信区间:1.94 至 2.79)。大流行对未满足医疗需求的不利影响在中年成年人(2.53,2.00 至 3.20)和老年成年人(2.00,1.48 至 2.69)、男性(2.24,1.74 至 2.90)和女性(2.34,1.82 至 3.03)中均普遍存在。一系列敏感性分析的结果仍然稳健。

结论

这些发现表明,政策制定者和医疗保健专业人员应努力平衡医疗资源,以充分满足个人对多种健康问题的综合医疗需求,同时考虑到大流行带来的挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b56f/11015184/6ab43b259409/bmjhci-2023-100865f01.jpg

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