COVID-19-specific prefectural hospital bed utilization rate and in-hospital mortality among COVID-19 patients throughout the first three years of the pandemic in Japan.
IF 3.7 2区 医学Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Hitomi Kimura, Mariko Hosozawa, Yuta Taniguchi, Kazumasa Yamagishi, Koji Kitajima, Mari Terada, Yusuke Asai, Norio Ohmagari, Hiroyasu Iso
{"title":"COVID-19-specific prefectural hospital bed utilization rate and in-hospital mortality among COVID-19 patients throughout the first three years of the pandemic in Japan.","authors":"Hitomi Kimura, Mariko Hosozawa, Yuta Taniguchi, Kazumasa Yamagishi, Koji Kitajima, Mari Terada, Yusuke Asai, Norio Ohmagari, Hiroyasu Iso","doi":"10.2188/jea.JE20240395","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>We examined the association between the COVID-19-specific prefectural bed utilization rate and in-hospital mortality during the first three years of the pandemic in Japan.</p><p><strong>Methods: </strong>This nationwide study included 58,175 COVID-19 patients from the COVID-19 Registry Japan, hospitalized between May 1, 2020 and November 30, 2022. Based on the weekly COVID-19-specific bed utilization rate in each prefecture at diagnosis, patients were categorized into four groups (< 25%, 25% to < 50%, 50% to < 75%, and ≥ 75%). Odds ratios (ORs) were estimated by fitting a generalized linear mixed model with prefecture as a random intercept and adjusting for covariates (age, gender, body mass index, smoking and drinking status, and comorbidities). Additional analyses according to age group, gender, and wave of the pandemic were conducted.</p><p><strong>Results: </strong>We observed 2312 (4.0%) all-cause in-hospital deaths. All-cause in-hospital mortality increased with higher COVID-19 bed utilization rates at diagnosis (OR for multivariable model 1.35, 95% confidence interval [CI] 1.19-1.54 for 25% to <50%; 1.89, 1.66-2.16 for 50 to <75%; 2.16, 1.80-2.58 for ≥75%; P for trend<0.0001). Stronger associations were noted among the younger population (aged <70 years, OR: 3.18, 1.96-5.19) and during the fourth (March 1-June 30, 2021, OR: 3.81, 2.13-6.80) and sixth pandemic waves (January 1-Jun 30, 2022, OR: 2.67, 1.68-4.23).</p><p><strong>Conclusions: </strong>Our results emphasize that preventing hospital bed shortages during outbreaks is an important public health strategy to reduce the associated mortality, particularly when new strains emerge and in younger people.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.7000,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Epidemiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2188/jea.JE20240395","RegionNum":2,"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: We examined the association between the COVID-19-specific prefectural bed utilization rate and in-hospital mortality during the first three years of the pandemic in Japan.
Methods: This nationwide study included 58,175 COVID-19 patients from the COVID-19 Registry Japan, hospitalized between May 1, 2020 and November 30, 2022. Based on the weekly COVID-19-specific bed utilization rate in each prefecture at diagnosis, patients were categorized into four groups (< 25%, 25% to < 50%, 50% to < 75%, and ≥ 75%). Odds ratios (ORs) were estimated by fitting a generalized linear mixed model with prefecture as a random intercept and adjusting for covariates (age, gender, body mass index, smoking and drinking status, and comorbidities). Additional analyses according to age group, gender, and wave of the pandemic were conducted.
Results: We observed 2312 (4.0%) all-cause in-hospital deaths. All-cause in-hospital mortality increased with higher COVID-19 bed utilization rates at diagnosis (OR for multivariable model 1.35, 95% confidence interval [CI] 1.19-1.54 for 25% to <50%; 1.89, 1.66-2.16 for 50 to <75%; 2.16, 1.80-2.58 for ≥75%; P for trend<0.0001). Stronger associations were noted among the younger population (aged <70 years, OR: 3.18, 1.96-5.19) and during the fourth (March 1-June 30, 2021, OR: 3.81, 2.13-6.80) and sixth pandemic waves (January 1-Jun 30, 2022, OR: 2.67, 1.68-4.23).
Conclusions: Our results emphasize that preventing hospital bed shortages during outbreaks is an important public health strategy to reduce the associated mortality, particularly when new strains emerge and in younger people.
期刊介绍:
The Journal of Epidemiology is the official open access scientific journal of the Japan Epidemiological Association. The Journal publishes a broad range of original research on epidemiology as it relates to human health, and aims to promote communication among those engaged in the field of epidemiological research and those who use epidemiological findings.