Division of Trauma and Surgical Critical Care, Department of Surgery, Associate Professor of Surgery, Drexel College of Medicine, Philadelphia PA, Christianacare Health System, Newark, Delaware.
Department of Surgery, Christianacare Health System, Newark, Delaware.
J Surg Res. 2024 Sep;301:512-519. doi: 10.1016/j.jss.2024.06.014. Epub 2024 Jul 22.
Higher incidences of interpersonal violence were reported throughout the country during the coronavirus (COVID) time period. We aimed to compare health-care encounters and resource utilization related to interpersonal violence with mental health (MH) disorders before and during the pandemic within a year of the index visit for interpersonal violence.
A retrospective analysis of the Delaware Healthcare Claims data of all patients aged ≥16 y who suffered interpersonal violence was performed. Patients were followed up for 1 y pre and post their index visit of interpersonal violence episode during the pre-COVID (March 2018 through December 2018) and the COVID (March 2020 through December 2020) period. Census tract information was used to assess social determinants of health.
There were 431 patients in the COVID period and 527 patients in the pre-COVID period with index violence claim encounters. African American patients were more likely to have a violence encounter during COVID (60.3% versus 47.2%, P < 0.001). Patients in the COVID period were more likely to live in a census tract with public assistance households (median 3.3% versus 2.2%, P = 0.005) and higher unemployment (7.5% versus 7.1%, P = 0.01). In the following year of index violence claim, the mean numbers of MH claim-days for COVID and pre-COVID patients were 19.5 (53.3) and 26.2 (66.2), (P = 0.51). The COVID group had fewer MH claim-days mostly in the second half of the year after the index encounter with an incidence rate ratio of 0.61, 95% CI (0.45-0.83).
Racial and socioeconomic disparities were amplified and MH resource utilization was lower during COVID. Further injury prevention efforts should be focused on MH in future pandemics or disasters.
在冠状病毒（COVID）期间，全国范围内报告了更高的人际暴力发生率。我们旨在比较 COVID 之前和期间与精神健康（MH）障碍相关的医疗保健遭遇和资源利用，在人际暴力的索引就诊后一年内。
对所有≥16 岁的因人际暴力而遭受伤害的患者进行了特拉华州医疗保健索赔数据的回顾性分析。在 COVID 之前（2018 年 3 月至 2018 年 12 月）和 COVID 期间（2020 年 3 月至 2020 年 12 月），对患者在其人际暴力发作的索引就诊前和后进行了为期 1 年的随访。使用人口普查区信息来评估健康的社会决定因素。
在 COVID 期间有 431 名患者，在 COVID 之前有 527 名患者有暴力事件就诊。在 COVID 期间，非裔美国人更有可能发生暴力事件（60.3%比 47.2%，P < 0.001）。在 COVID 期间，患者更有可能居住在有公共援助家庭的人口普查区（中位数 3.3%比 2.2%，P = 0.005）和更高的失业率（7.5%比 7.1%，P = 0.01）。在索引暴力索赔后的下一年，COVID 和 COVID 前患者的 MH 索赔天数的平均值分别为 19.5（53.3）和 26.2（66.2），（P = 0.51）。COVID 组 MH 索赔天数较少，主要集中在索引后半年，发生率比为 0.61，95%置信区间（0.45-0.83）。
种族和社会经济差异加剧，COVID 期间 MH 资源利用减少。在未来的大流行或灾难中，应更加关注 MH 进行进一步的伤害预防工作。
