COVID-19大流行对西班牙加泰罗尼亚艾滋病毒感染者医疗服务利用的影响:一项基于人群的队列研究

IF 2.6 4区医学 Q3 INFECTIOUS DISEASES

Enfermedades infecciosas y microbiologia clinica Pub Date : 2024-12-01 DOI:10.1016/j.eimc.2023.09.001

Yi-Hua Pan , Daniel K. Nomah , Marcos Montoro-Fernandez , Sergio Moreno-Fornés , Yesika Díaz , Jordi Aceitón , Andreu Bruguera , Josep M. Llibre , Pere Domingo , Arkaitz Imaz , Ingrid Vilaró , Vicenç Falcó , Juliana Reyes-Urueña , José M. Miro , Jordi Casabona , the PISCIS Cohort Study Group

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引用次数: 0

摘要

COVID-19大流行扰乱了医疗服务的使用。我们估计了COVID-19大流行对西班牙加泰罗尼亚艾滋病毒感染者(PLWH)医疗服务利用的影响。从2017年1月1日至2020年12月31日，我们调查了PISCIS队列中17738名PLWH的HIV单位、初级保健、医院和急诊科的公共医疗保健使用情况。我们使用自回归综合移动平均进行了中断时间序列分析，以估计COVID-19对PLWH中就诊和艾滋病毒监测的影响。在封锁期间，总体就诊人数下降了17.1% (95% CI:[- 29.4, 0.4])，但没有显著下降，随后稳步恢复，直到2020年底。在封锁期间，有三家卫生机构的就诊人数出现了统计上的显著下降:艾滋病毒病房(- 44.8%[- 56.7，- 23.6])、医院(- 40.4%[- 52.8，- 18.1])和急诊科(- 36.9% [- 47.0，- 21.9]);此后，访问开始稳步增加，但没有达到截至2020年12月的水平。相比之下，初级保健访问在封锁期间保持不变，为1.9%(95%置信区间:- 13.5,23.9)。在封锁期间，实验室监测CD4细胞(54.2% [95% CI: - 64.4， - 36.0])和HIV RNA病毒载量(53.1% [95% CI: - 62.9， - 36.1])显著下降。COVID-19封锁严重影响了公共卫生机构的面对面医疗服务使用。然而，医疗保健利用的减少并未影响初级保健服务。尽管服务逐渐恢复到大流行前的水平，但必须有效地为未来的大流行做好准备，并采取措施确保在大流行封锁期间继续向PLWH提供护理。COVID-19大流行interrumpió卫生服务中心。2019冠状病毒病大流行影响评估报告(网址:utilización)网址:艾滋病毒/艾滋病(PVV)患者健康服务报告(网址:Cataluña, España)。医疗器械和医疗器械有限公司pública在VIH大学、atención初级、医院和急救中心的注册信息，2017年1月1日至2020年1月31日。实现análisis一系列临时跨越性利用与预估móvil整合自回归与预估COVID-19的效果，并与其他咨询机构进行了协商，并与VIH中心和PVV进行了比较。Se observó una disminución no significant va del 17.1% (IC 95%: - 29,4 a 0,4)， en las visitas m ())， secguida de una reanudación constante hasta finales de 2020。医院(- 44,8% [- 56,7 a - 23,6])、医院(- 40,4% [- 52,8 a - 18,1])和急诊科(- 36,9% [- 47,0 a - 21,9]);在2020年之前，我们将为您提供一种全新的体验，一种全新的体验。Por el contrario, las visitas de atención primaria se mantuvieron sin cambios durante el confinamiento en 1,9% (IC IC 95%:−13,5 a 23,9)。El control de las analíticas de ccvlulas CD4 (54,2% [IC 95%:−64,4 a−36,0])和de la carga viral de ARN del VIH (53,1% [IC 95%:−62,9 a−36,1])均有显著性差异。COVID-19组织间的显著性变化及其对atención与个人有关的组织间的服务的影响。在禁运期间，la reducción en la utilización de la atención卫生保健没有afectó a los servicios de atención primary。在大流行之前，必须为预防大流行的有效管理做好必要的准备;在大流行之前，必须为预防大流行的有效管理做好必要的准备;在大流行之前，必须为预防大流行的持续atención做好必要的准备;在大流行之前，必须为预防大流行的持续atención做好准备。

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The impact of the COVID-19 pandemic on healthcare services utilization among people living with HIV in Catalonia, Spain: A population-based cohort study

Background

The COVID-19 pandemic disrupted healthcare services usage. We estimated the impact of the COVID-19 pandemic on healthcare services utilization among people living with HIV (PLWH) in Catalonia, Spain.

Methods

We accessed public healthcare usage in HIV units, primary care, hospitals, and emergency departments among 17,738 PLWH in the PISCIS cohort from January 1, 2017, to December 31, 2020. We performed an interrupted time series analysis using the autoregressive integrated moving average to estimate the effect of COVID-19 on medical visits and HIV monitoring among PLWH.

Results

A non-significant decrease of 17.1% (95% CI: [−29.4, 0.4]) in overall medical visits was observed during the lockdown, followed by a steady resumption until the end of 2020. Three health facilities presented statistically significant declines in visits during the lockdown: HIV units (−44.8% [−56.7, −23.6]), hospitals (−40.4% [−52.8, −18.1]), and emergency departments (−36.9% [−47.0, −21.9]); thereafter, the visits have begun to increase steadily but not to previous levels as of December 2020. In contrast, primary care visits remained unchanged during the lockdown by 1.9% (95% CI: −13.5, 23.9). CD4 cell (54.2% [95% CI: −64.4, −36.0]) and HIV RNA viral load (53.1% [95% CI: −62.9, −36.1]) laboratory monitoring reduced significantly during the lockdown.

Conclusion

COVID-19 lockdowns significantly disrupted in-person healthcare services usage among PLWH. The reduction in healthcare utilization however did not affect primary care services. Despite services gradually rebounding to pre-pandemic levels, it is imperative to effectively prepare for future pandemics and implement measures to ensure continuous provision of care to PLWH during pandemic lockdowns.

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来源期刊

Enfermedades infecciosas y microbiologia clinica 医学-传染病学

CiteScore

2.10

自引率

8.00%

发文量

194

审稿时长

29 days

期刊介绍： Hoy está universalmente reconocida la renovada y creciente importancia de la patología infecciosa: aparición de nuevos agentes patógenos, de cepas resistentes, de procesos con expresión clínica hasta ahora desconocida, de cuadros de una gran complejidad. Paralelamente, la Microbiología y la Infectología Clínicas han experimentado un gran desarrollo como respuesta al reto planteado por la actual patología infecciosa. Enfermedades Infecciosas y Microbiología Clínica es la Publicación Oficial de la Sociedad Española SEIMC. Cumple con la garantía científica de esta Sociedad, la doble función de difundir trabajos de investigación, tanto clínicos como microbiológicos, referidos a la patología infecciosa, y contribuye a la formación continuada de los interesados en aquella patología mediante artículos orientados a ese fin y elaborados por autores de la mayor calificación invitados por la revista.