282080名新冠后症状长期患者两年的医疗保健利用情况：一项多重匹配对照纵向队列分析

Healthcare utilisation of 282,080 individuals with long COVID over two years: a multiple matched control, longitudinal cohort analysis.

作者信息

Mu Yi, Dashtban Ashkan, Mizani Mehrdad A, Tomlinson Chris, Mohamed Mohamed, Ashworth Mark, Mamas Mamas, Priedon Rouven, Petersen Steffen, Kontopantelis Evan, Horstmanshof Kim, Pagel Christina, Hocaoğlu Mevhibe, Khunti Kamlesh, Williams Richard, Thygesen Johan, Lorgelly Paula, Gomes Manuel, Heightman Melissa, Banerjee Amitava

机构信息

Institute of Health Informatics, University College London, London, UK.

British Heart Foundation Data Science Centre, Health Data Research UK, London, UK.

出版信息

J R Soc Med. 2024 Nov;117(11):369-381. doi: 10.1177/01410768241288345. Epub 2024 Nov 27.

DOI:10.1177/01410768241288345

PMID:39603265

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11603423/

Abstract

OBJECTIVES

To investigate healthcare utilisation and cost in individuals with long COVID (LC) at population level.

DESIGN

Case-control cohort analysis with multiple age-, sex-, ethnicity-, deprivation-, region- and comorbidity-matched control groups: (1) COVID only, no LC; (2) pre-pandemic; (3) contemporary non-COVID; and (4) pre-LC (self-controlled, pre-COVID pandemic).

SETTING

National, population-based, linked UK electronic health records (British Heart Foundation/NHS England Secure Data Environment).

PARTICIPANTS

Adults aged ≥18 years with LC between January 2020 and January 2023.

MAIN OUTCOME MEASURES

Healthcare utilisation (number of consultations/visits per person: primary care (general practitioner [GP]), secondary care (outpatient [OP], inpatient [IP] and emergency department [ED], investigations and procedures) and inflation-adjusted cost (£) for LC and control populations per month, calendar year and pandemic year for each category.

RESULTS

A total of 282,080 individuals with LC were included between January 2020 and January 2023. The control groups were COVID only, no LC ( = 1,112,370), pre-pandemic ( = 1,031,285), contemporary non-COVID ( = 1,118,360) and pre-LC ( = 282,080). Healthcare utilisation per person (per month/year) was higher in LC than controls across GP, OP and ED. For IP, LC had higher healthcare utilisation than pre-LC and contemporary non-COVID (all < 0.0001). Healthcare utilisation of the LC group increased progressively between 2020 and 2023, compared with controls. Median cost per patient/year was also higher in individuals with LC than all control groups.

CONCLUSIONS

LC has been associated with substantial, persistent healthcare utilisation and cost over the last three years. Future funding, resources and staff for LC prevention, treatment and research must be prioritised to reduce sustained primary and secondary healthcare utilisation and costs.

摘要

目的

在人群层面调查长新冠（LC）患者的医疗服务利用情况和费用。

设计

采用病例对照队列分析，设置多个年龄、性别、种族、贫困程度、地区和合并症匹配的对照组：（1）仅感染新冠，无长新冠；（2）疫情前；（3）当代非新冠患者；（4）长新冠之前（自我对照，新冠疫情前）。

背景

基于英国全国人口的关联电子健康记录（英国心脏基金会/英国国家医疗服务体系英格兰安全数据环境）。

参与者

2020年1月至2023年1月期间年龄≥18岁的长新冠成年患者。

主要观察指标

医疗服务利用情况（每人的咨询/就诊次数：初级医疗（全科医生[GP]）、二级医疗（门诊[OP]、住院[IP]和急诊科[ED]）、检查和操作）以及长新冠患者和对照组人群每月、历年和疫情年份各分类的通胀调整费用（英镑）。

结果

2020年1月至2023年1月期间共纳入282,080例长新冠患者。对照组为仅感染新冠，无长新冠（n = 1,112,370）、疫情前（n = 1,031,285）、当代非新冠患者（n = 1,118,360）和长新冠之前（n = 282,080）。在全科医生、门诊和急诊科方面，长新冠患者每人（每月/每年）的医疗服务利用情况高于对照组。对于住院治疗，长新冠患者的医疗服务利用情况高于长新冠之前和当代非新冠患者（均P < 0.0001）。与对照组相比，2020年至2023年长新冠患者组的医疗服务利用情况逐渐增加。长新冠患者的患者每年中位数费用也高于所有对照组。