Casanova Georgia, Lillini Roberto, Lamura Giovanni
Centre for Socio-Economic Research on Ageing, IRCCS-INRCA National Institute of Health and Science on Ageing, 60124 Ancona, Italy.
Data Science Unit, Department of Epidemiology and Data Science, IRCCS National Cancer Institute Foundation (INT), 20133 Milan, Italy.
Healthcare (Basel). 2024 Oct 8;12(19):2006. doi: 10.3390/healthcare12192006.
The main outcomes of the COVID-19 pandemic can be used to assess the capability and sustainability of public healthcare and Long-Term Care (LTC) systems. This study aims to identify the population's demographic and socio-economic characteristics, as well as other national resources associated with the incidence and mortality of COVID-19, by comparing three European countries during the first pandemic period (Italy, Spain, and Germany). The results will identify possible strengths and weaknesses that could be considered as hints of the need for health and social intervention. Variables describing the countries' core demographics, socio-economic characteristics, and national resources were collected from 2001-2021 from well-established international databases. COVID-19 incidence and death figures from 1 March 2020 to 31 March 2021 were extracted from national health databases. Analysis focused on bivariate and weighted multivariable linear regressions between incidence, mortality, and socio-economic covariates. Findings show that both care models and socio-demographic characteristics influenced the capability of the first year's response to the COVID-19 emergency. Formal public care appears to represent the most effective strategy against incidence and mortality regarding COVID-19, especially for older people, because it mitigates the adverse effects of socio-economic characteristics. Current strategies oriented towards privatizing care should, therefore, be considered critically, since they may result in weaker protection of vulnerable groups, such as frail older people, due to the unequal position of individuals with different socio-economic conditions in purchasing services from the care market.
新冠疫情的主要结果可用于评估公共医疗保健和长期护理（LTC）系统的能力及可持续性。本研究旨在通过比较三个欧洲国家（意大利、西班牙和德国）在疫情第一阶段的情况，确定与新冠发病率和死亡率相关的人口的人口统计学和社会经济特征，以及其他国家资源。研究结果将确定可能的优势和劣势，这些可被视为健康和社会干预需求的线索。描述各国核心人口统计学、社会经济特征和国家资源的变量是从2001年至2021年从成熟的国际数据库中收集的。2020年3月1日至2021年3月31日的新冠发病率和死亡数据是从各国卫生数据库中提取的。分析重点在于发病率、死亡率与社会经济协变量之间的双变量和加权多变量线性回归。研究结果表明，护理模式和社会人口特征都影响了第一年应对新冠疫情紧急情况的能力。正规公共护理似乎是应对新冠发病率和死亡率最有效的策略，尤其是对老年人而言，因为它减轻了社会经济特征的不利影响。因此，当前倾向于护理私有化的策略应受到严格审视，因为由于不同社会经济状况的个人在从护理市场购买服务时处于不平等地位，这些策略可能导致对弱势群体（如体弱老年人）的保护减弱。
