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新冠大流行期间俄勒冈州发病后的健康相关社会需求。

Health-Related Social Needs Following Onset of the COVID-19 Pandemic in Oregon.

机构信息

Oregon Rural Practice-based Research Network, Oregon Health & Science University, Portland, Oregon.

OCHIN, Portland, Oregon.

出版信息

Ann Fam Med. 2024 Nov-Dec;22(6):476-482. doi: 10.1370/afm.3167.

Abstract

PURPOSE

Efforts during the COVID-19 pandemic to address the health-related social needs (HRSN) of Medicare and Medicaid beneficiaries, such as food and housing, were insufficient. We examined HRSN data from the Accountable Health Communities study collected in Oregon to understand changes in these needs at the onset and during the first 2 years of the pandemic.

METHODS

We conducted an interrupted time series analysis with data from 21,522 Medicare and Medicaid beneficiaries screened for overall HRSN between May 13, 2019 and December 24, 2021. Secondary interrupted time series analyses were conducted for each type of HRSN assessed with the Accountable Health Communities screening tool: food, housing, transportation, utilities, and interpersonal safety.

RESULTS

The interrupted time series analysis indicated an abrupt 17.7-percentage point increase in overall HRSN around March 23, 2020, which did not significantly decline during the subsequent 2 years. Food, housing, and interpersonal safety needs increased by 16.5, 15.9, and 4.4 percentage points, respectively, with no significant decline thereafter. Transportation and utility needs increased by 7.2 and 7.5 percentage points, respectively, but decreased significantly after the start of the pandemic (decreasing by 0.2 and 0.1 percentage points each week, respectively).

CONCLUSIONS

The jump in HRSN following the start of the pandemic and the persistence of need, particularly in food and housing, highlight the importance of research to better understand which public health and health care interventions, investments, and policies effectively address HRSN.

摘要

目的

在 COVID-19 大流行期间,为满足医疗保险和医疗补助受益人的与健康相关的社会需求(HRSN),例如食物和住房,所做的努力并不充分。我们研究了在俄勒冈州进行的责任健康社区研究中收集的 HRSN 数据,以了解大流行开始时和前 2 年这些需求的变化。

方法

我们对 21522 名接受全面 HRSN 筛查的医疗保险和医疗补助受益人的数据进行了中断时间序列分析,这些数据是在 2019 年 5 月 13 日至 2021 年 12 月 24 日之间收集的。使用责任健康社区筛查工具评估的每种 HRSN 类型(食物、住房、交通、公用事业和人际关系安全)进行了二次中断时间序列分析。

结果

中断时间序列分析表明,2020 年 3 月 23 日左右,整体 HRSN 突然增加了 17.7 个百分点,在随后的 2 年中没有显著下降。此后,食物、住房和人际关系安全需求分别增加了 16.5、15.9 和 4.4 个百分点,此后没有显著下降。交通和公用事业需求分别增加了 7.2%和 7.5%,但在大流行开始后显著下降(每周分别减少 0.2%和 0.1%)。

结论

大流行开始后 HRSN 的跃升以及需求的持续存在,特别是在食物和住房方面,凸显了进行研究的重要性,以便更好地了解哪些公共卫生和医疗保健干预、投资和政策能有效地解决 HRSN。

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