Department of Surgery Outcomes Research Center, Howard University College of Medicine, Washington, DC, United States.
Department of Health Policy and Management, University of Maryland, College Park, MD, United States.
Front Public Health. 2024 Jul 18;12:1412671. doi: 10.3389/fpubh.2024.1412671. eCollection 2024.
Community-acquired pneumonia (CAP) is a major health concern in the United States (US), with its incidence, severity, and outcomes influenced by social determinants of health, including socioeconomic status. The impact of neighborhood socioeconomic status, as measured by the Distressed Communities Index (DCI), on CAP-related admissions remains understudied in the literature.
To determine the independent association between DCI and CAP-related admissions in Maryland.
We conducted a retrospective study using the Maryland State Inpatient Database (SID) to collate data on CAP-related admissions from January 2018 to December 2020. The study included adults aged 18-85 years. We explored the independent association between community-level economic deprivation based on DCI quintiles and CAP-related admissions, adjusting for significant covariates.
In the study period, 61,467 cases of CAP-related admissions were identified. The patients were predominantly White (49.7%) and female (52.4%), with 48.6% being over 65 years old. A substantive association was found between the DCI and CAP-related admissions. Compared to prosperous neighborhoods, patients living in economically deprived communities had 43% increased odds of CAP-related admissions.
Residents of the poorest neighborhoods in Maryland have the highest risk of CAP-related admissions, emphasizing the need to develop effective public health strategies beneficial to the at-risk patient population.
社区获得性肺炎（CAP）是美国的一个主要健康问题，其发病率、严重程度和结局受到健康的社会决定因素的影响，包括社会经济地位。邻里社会经济地位的影响，如通过贫困社区指数（DCI）衡量的，对 CAP 相关入院的影响在文献中研究不足。
确定 DCI 与马里兰州 CAP 相关入院之间的独立关联。
我们使用马里兰州住院患者数据库（SID）进行了一项回顾性研究，以收集 2018 年 1 月至 2020 年 12 月期间 CAP 相关入院的数据。研究对象为 18-85 岁的成年人。我们探讨了基于 DCI 五分位数的社区经济贫困程度与 CAP 相关入院之间的独立关联，并对重要协变量进行了调整。
在研究期间，确定了 61467 例 CAP 相关入院病例。患者主要为白人（49.7%）和女性（52.4%），65 岁以上者占 48.6%。发现 DCI 与 CAP 相关入院之间存在实质性关联。与繁荣社区相比，居住在经济贫困社区的患者 CAP 相关入院的几率增加了 43%。
马里兰州最贫困社区的居民 CAP 相关入院风险最高，这强调了需要制定对高危患者群体有益的有效公共卫生策略。
