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The Effect of the COVID-19 Pandemic on Non-COVID-19 Deaths: Population-Wide Retrospective Cohort Study.

التفاصيل البيبلوغرافية
العنوان: The Effect of the COVID-19 Pandemic on Non-COVID-19 Deaths: Population-Wide Retrospective Cohort Study.
المؤلفون: Wai AK; Department of Emergency Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong).; Department of Accident & Emergency, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.; Department of Accident & Emergency, Queen Mary Hospital, Hong Kong, China (Hong Kong)., Yip TF; School of Biomedical Sciences, The University of Hong Kong, Hong Kong, China (Hong Kong)., Wong YH; School of Biomedical Sciences, The University of Hong Kong, Hong Kong, China (Hong Kong)., Chu CK; Department of Emergency Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)., Lee T; Department of Emergency Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)., Yu KHO; School of Biomedical Sciences, The University of Hong Kong, Hong Kong, China (Hong Kong)., So WL; Department of Emergency Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)., Wong JYH; School of Nursing & Health Studies, Hong Kong Metropolitan University, Kowloon, China (Hong Kong)., Wong CK; Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China (Hong Kong)., Ho JW; School of Biomedical Sciences, The University of Hong Kong, Hong Kong, China (Hong Kong)., Rainer T; Department of Emergency Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong).
المصدر: JMIR public health and surveillance [JMIR Public Health Surveill] 2024 Feb 13; Vol. 10, pp. e41792. Date of Electronic Publication: 2024 Feb 13.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: JMIR Publications Country of Publication: Canada NLM ID: 101669345 Publication Model: Electronic Cited Medium: Internet ISSN: 2369-2960 (Electronic) Linking ISSN: 23692960 NLM ISO Abbreviation: JMIR Public Health Surveill Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Toronto : JMIR Publications, [2015]-
مواضيع طبية MeSH: COVID-19*, Humans ; Aged ; Pandemics ; Retrospective Studies ; Emergency Room Visits ; Health Personnel
مستخلص: Background: Health care avoidance in the COVID-19 pandemic has been widely reported. Yet few studies have investigated the dynamics of hospital avoidance behavior during pandemic waves and inferred its impact on excess non-COVID-19 deaths.
Objective: This study aimed to measure the impact of hospital avoidance on excess non-COVID-19 deaths in public hospitals in Hong Kong.
Methods: This was a retrospective cohort study involving 11,966,786 patients examined between January 1, 2016, and December 31, 2021, in Hong Kong. All data were linked to service, treatment, and outcomes. To estimate excess mortality, the 2-stage least squares method was used with daily tallies of emergency department (ED) visits and 28-day mortality. Records for older people were categorized by long-term care (LTC) home status, and comorbidities were used to explain the demographic and clinical attributes of excess 28-day mortality. The primary outcome was actual excess death in 2020 and 2021. The 2-stage least squares method was used to estimate the daily excess 28-day mortality by daily reduced visits.
Results: Compared with the prepandemic (2016-2019) average, there was a reduction in total ED visits in 2020 of 25.4% (548,116/2,142,609). During the same period, the 28-day mortality of non-COVID-19 ED deaths increased by 7.82% (2689/34,370) compared with 2016-2019. The actual excess deaths in 2020 and 2021 were 3143 and 4013, respectively. The estimated total excess non-COVID-19 28-day deaths among older people in 2020 to 2021 were 1958 (95% CI 1100-2820; no time lag). Deaths on arrival (DOAs) or deaths before arrival (DBAs) increased by 33.6% (1457/4336) in 2020, while non-DOA/DBAs increased only by a moderate 4.97% (1202/24,204). In both types of deaths, the increases were higher during wave periods than in nonwave periods. Moreover, non-LTC patients saw a greater reduction in ED visits than LTC patients across all waves, by more than 10% (non-LTC: 93,896/363,879, 25.8%; LTC: 7,956/67,090, 11.9%). Most of the comorbidity subsets demonstrated an annualized reduction in visits in 2020. Renal diseases and severe liver diseases saw notable increases in deaths.
Conclusions: We demonstrated a statistical method to estimate hospital avoidance behavior during a pandemic and quantified the consequent excess 28-day mortality with a focus on older people, who had high frequencies of ED visits and deaths. This study serves as an informed alert and possible investigational guideline for health care professionals for hospital avoidance behavior and its consequences.
(©Abraham Ka-chung Wai, Tsz Fung Yip, Yui Hang Wong, Chun Kit Chu, Teddy Lee, Ken Hung On Yu, Wang Leong So, Janet Y H Wong, Carlos King-ho Wong, Joshua W Ho, Timothy Rainer. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 13.02.2024.)
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فهرسة مساهمة: Keywords: COVID-19; Hong Kong; avoidance; causal inference; cohort; death; death rate; death toll; emergency department; epidemiology; excess; excess death; health care; health care avoidance; hospital; hospital avoidance behavior; hospital care; impact; mortality; population
تواريخ الأحداث: Date Created: 20240213 Date Completed: 20240214 Latest Revision: 20240216
رمز التحديث: 20240216
مُعرف محوري في PubMed: PMC10866203
DOI: 10.2196/41792
PMID: 38349717
قاعدة البيانات: MEDLINE
الوصف
تدمد:2369-2960
DOI:10.2196/41792