The Impact of Healthcare Pressures on the COVID-19 Hospitalisation Fatality Risk in England.

IF 3.8 4区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Journal of Epidemiology and Global Health Pub Date : 2024-10-08 DOI:10.1007/s44197-024-00310-9

Jonathon Mellor, Owen Jones, Thomas Ward

{"title":"The Impact of Healthcare Pressures on the COVID-19 Hospitalisation Fatality Risk in England.","authors":"Jonathon Mellor, Owen Jones, Thomas Ward","doi":"10.1007/s44197-024-00310-9","DOIUrl":null,"url":null,"abstract":"Background: As the impact of the SARS-CoV-2 pandemic extends into 2023 and beyond, the treatment and outcomes of infected patients continues to evolve. Unlike earlier in the pandemic there are now further infectious disease pressures placed on hospitals, which influence patient care and triage decisions.Methods: The manuscript uses individual patient records linked with associated hospital management information of system pressure characteristics to attribute COVID-19 hospitalisation fatality risks (HFR) to patients and hospitals, using generalised additive mixed effects models.Results: Between 01 September 2022 and 09 October 2023, the COVID-19 hospitalisation fatality risk in England was estimated as 12.71% (95% confidence interval (CI) 12.53%, 12.88%). Staff absences had an adjusted odds ratio of 1.038 (95% CI 1.017, 1.060) associated with the HFR when accounting for patient and hospital characteristics.Interpretation: This observational research presents evidence that a range of local hospital effects can have a meaningful impact on the risk of death from COVID-19 once hospitalised and should be accounted for when reporting estimates. We show that both the patient case mix and hospital pressures impact estimates of patient outcomes.","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":null,"pages":null},"PeriodicalIF":3.8000,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Epidemiology and Global Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s44197-024-00310-9","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}

引用次数: 0

Abstract

Background: As the impact of the SARS-CoV-2 pandemic extends into 2023 and beyond, the treatment and outcomes of infected patients continues to evolve. Unlike earlier in the pandemic there are now further infectious disease pressures placed on hospitals, which influence patient care and triage decisions.

Methods: The manuscript uses individual patient records linked with associated hospital management information of system pressure characteristics to attribute COVID-19 hospitalisation fatality risks (HFR) to patients and hospitals, using generalised additive mixed effects models.

Results: Between 01 September 2022 and 09 October 2023, the COVID-19 hospitalisation fatality risk in England was estimated as 12.71% (95% confidence interval (CI) 12.53%, 12.88%). Staff absences had an adjusted odds ratio of 1.038 (95% CI 1.017, 1.060) associated with the HFR when accounting for patient and hospital characteristics.

Interpretation: This observational research presents evidence that a range of local hospital effects can have a meaningful impact on the risk of death from COVID-19 once hospitalised and should be accounted for when reporting estimates. We show that both the patient case mix and hospital pressures impact estimates of patient outcomes.

查看原文本刊更多论文

英格兰医疗压力对 COVID-19 住院死亡风险的影响。

背景：随着 SARS-CoV-2 大流行的影响延续到 2023 年及以后，受感染病人的治疗和结果也在不断变化。与大流行初期不同的是，现在医院面临着更大的传染病压力，这影响了病人护理和分流决策：本文采用广义加性混合效应模型，将患者的个人病历与相关医院的系统压力特征管理信息联系起来，将 COVID-19 住院死亡风险（HFR）归因于患者和医院：2022年9月1日至2023年10月9日期间，英格兰的COVID-19住院死亡风险估计为12.71%（95%置信区间（CI）为12.53%，12.88%）。在考虑患者和医院特征的情况下，员工缺勤与住院死亡风险的调整后几率比为 1.038（95% 置信区间为 1.017，1.060）：这项观察性研究提供的证据表明，当地医院的一系列影响会对患者住院后因 COVID-19 死亡的风险产生重大影响，因此在报告估计值时应将其考虑在内。我们表明，患者病例组合和医院压力都会影响患者预后的估计值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Epidemiology and Global Health Medicine-Epidemiology

CiteScore

10.70

自引率

1.40%

发文量

审稿时长

19 weeks

期刊介绍： The Journal of Epidemiology and Global Health is an esteemed international publication, offering a platform for peer-reviewed articles that drive advancements in global epidemiology and international health. Our mission is to shape global health policy by showcasing cutting-edge scholarship and innovative strategies.