scholarly journals Decline in hospitalization for all medical conditions during the COVID-19 pandemic

2020 ◽  
Vol 3 (2) ◽  
pp. 103-110
Author(s):  
Alin Cristinel Cotigă ◽  
Claudiu Ivan ◽  
Silvia Nica ◽  
Mirela Zivari
Keyword(s):  
Hospital Admissions ◽  
Hospitalization Rate ◽  
Medical Emergency ◽  
Medical Services ◽  
Emergency Hospital ◽  
Admission Rates ◽  
Health Authorities ◽  
Public Health Authorities ◽  
The University ◽  
The Impact

AbstractIntroduction: Hospital admissions fell dramatically in Romania during the COVID-19 pandemic partially due to urgent legislation for controlling the infection rates that influenced the selection criteria for hospitalization and also due to fear of infection with SARS-CoV-2 which resulted in avoiding medical services.Aim: This study aimed to assess the impact of COVID-19 pandemic on the population availability to access medical services by comparing the admission rates for all departments of the University Emergency Hospital, Bucharest, from March to August 2019 and March to August 2020.Methods: A cohort of 38.730 patients was analyzed according to hospitalization rate from March to August 2019 and March to August 2020.Results: From March to August 2020 patients were hospitalized as a result of a medical emergency rather than an appointment, as outpatient and hospitalization rates changed dramatically. Thus, 67.4% accessed hospitalization from March to August 2019 and 32.6% accessed hospitalization from March to August 2020. The proportion of the patients admitted from the Ambulatory Care Unit decreased significantly from 44.2% in 2019 to 32.7% in 2020. Also, the structure of the patients’ profile has been affected.Discussion: The COVID-19 pandemic period in 2020 (March-September) affected the hospitalization rate and the structure of the patients’ profile that came to the University Emergency Hospital in Bucharest, Romania.Conclusion: The patients who would have accessed the medical health services that might have resulted in hospitalization could have resulted in out-of-hospital deaths and this should also be the focus of the public health authorities.

scholarly journals Impact of the COVID-19 pandemic on cardiovascular mortality and catherization activity during the lockdown in central Germany: an observational study

2020 ◽  
Author(s):  
Holger M. Nef ◽  
◽  
Albrecht Elsässer ◽  
Helge Möllmann ◽  
Mohammed Abdel-Hadi ◽  
...  
Keyword(s):  
Cardiovascular Mortality ◽  
Hospital Admissions ◽  
Central Germany ◽  
Coronary Syndrome ◽  
Health Authorities ◽  
Time Period ◽  
Public Health Authorities ◽  
Cardiac Catherization ◽  
The Impact ◽  
Hospital Cardiac Arrest

Abstract Aims During the COVID-19 pandemic, hospital admissions for cardiac care have declined. However, effects on mortality are unclear. Thus, we sought to evaluate the impact of the lockdown period in central Germany on overall and cardiovascular deaths. Simultaneously we looked at catheterization activities in the same region. Methods and results Data from 22 of 24 public health-authorities in central Germany were aggregated during the pandemic related lockdown period and compared to the same time period in 2019. Information on the total number of deaths and causes of death, including cardiovascular mortality, were collected. Additionally, we compared rates of hospitalization (n = 5178) for chronic coronary syndrome (CCS), acute coronary syndrome (ACS), and out of hospital cardiac arrest (OHCA) in 26 hospitals in this area. Data on 5,984 deaths occurring between March 23, 2020 and April 26, 2020 were evaluated. In comparison to the reference non-pandemic period in 2019 (deaths: n = 5832), there was a non-significant increase in all-cause mortality of 2.6% [incidence rate ratio (IRR) 1.03, 95% confidence interval (CI) 0.99–1.06; p = 0.16]. Cardiovascular and cardiac mortality increased significantly by 7.6% (IRR 1.08, 95%-CI 1.01–1.14; p = 0.02) and by 11.8% (IRR 1.12, 95%-CI 1.05–1.19; p < 0.001), respectively. During the same period, our data revealed a drop in cardiac catherization procedures. Conclusion During the COVID-19-related lockdown a significant increase in cardiovascular mortality was observed in central Germany, whereas catherization activities were reduced. The mechanisms underlying both of these observations should be investigated further in order to better understand the effects of a pandemic-related lockdown and social-distancing restrictions on cardiovascular care and mortality. Graphic abstract

scholarly journals XarxaSalut, network of municipalities for health, Valencia Region (Spain): policy process evaluation

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
R Peiró Pérez ◽  
E Pérez Sanz ◽  
E Legaz Sanchez ◽  
J Quiles Izquierdo ◽  
Grupo XarxaSalut
Keyword(s):  
Process Evaluation ◽  
Citizen Participation ◽  
Policy Process ◽  
Local Level ◽  
Common Language ◽  
Health Authorities ◽  
Open Questions ◽  
Economic Support ◽  
Public Health Authorities ◽  
The Impact

Abstract “XarxaSalut” started in 2017, with the municipalities that have taken the commitment to boost the Promotion of Health (HP) at the local level through community participation, intersectorality and equity perspective. The objective is to present a policy process evaluation (2'5 years) of the implementation of XarxaSalut. Different approaches have been used; a questionnaire addressed to the municipalities at the time of adhesion including data on intersectorality, participation, HP actions and open questions; description of instruments that Regional Public Health Authorities (RPHA) has mobilized and an analysis of barriers and strengths made by the coordination office. In 2017, 17 municipalities were joined, being 197 in February 2020 (70% of the population). 65% are in a process of an organizational change through the intersectoral, decision making and participative working group. 35% are doing analysis of determinants and /or health situation, assets maps and a prioritization of HP actions. The main barriers identified by municipalities are lack of economic and personal resources, and difficulties in achieve citizen participation. The main benefits were the optimization of resources, the exchange of experiences, training, or economic support from the RPHA. Some support instruments develop for RPHA are a collection of guides for community development, funds that the municipalities can apply to support actions related with training, HP action on vulnerable population, on asset maps, participation processes, vulnerable neighborhoods, etc.; Community actions have been included in the “Health Observatory” to give visibility and social support to XarxaSalut. Interdisciplinary training processes with health and municipal professionals have been made in order to develop a common language and strength the competences for HP. Lesson learned: The need to improve coordination and a common language between different types of participants and professionals Key messages The decision makers and professionals in the municipalities understand the impact in health of the policies developed at local level but needs guide and support to deal with it. The coordination between different administrations and primary health at local level and the misunderstandings about health and their determinants are the main aspect to reinforce.

scholarly journals The Impact of Covid-19 Public Health Policies on Persons with Disability and their Caregivers in Malta

2021 ◽  
Vol 4 (2) ◽  
pp. 25-37
Author(s):  
Andrew Camilleri ◽  
Samantha Pace Gasan ◽  
Andrew Azzopardi
Keyword(s):  
Public Health ◽  
World Health Organisation ◽  
World Health ◽  
Persons With Disabilities ◽  
Health Authorities ◽  
Essential Services ◽  
Public Health Authorities ◽  
Novel Coronavirus ◽  
Restrictive Measures ◽  
The Impact

On March 11, 2020, the World Health Organisation (WHO) declared a global health pandemic, due to the spread of a novel coronavirus, later named “Covid-19”. The spread of Covid-19 led to social isolation, distancing and a number of restrictive measures in Malta.  The aim of this paper is to analyse the impact of Covid-19 and the subsequent restrictive measures on persons with disability and their caregivers and families in Malta. Using thematic analysis, the study found that a variety of impacts ranging from a sense of isolation, lack of essential services being provided, additional difficulties encountered at the place of work and education and measures that were not sufficiently tailored for persons with disability issued by public health authorities. Underlying the additional difficulties brought about by Covid-19, structural difficulties to access essential services as well as ignorance from policy makers and politicians and the added “vulnerable-ization” of persons with disabilities were found to be highly impacting factors that pervade the experience of persons with disabilities and their caregivers.

scholarly journals Geospatial Analysis and Mapping Strategies for Fine Grained and Detailed COVID-19 Data With Geographic Information Systems

2021 ◽  
Author(s):  
ÁNGEL MIRAMONTES CARBALLADA ◽  
JOSE BALSA-BARREIRO
Keyword(s):  
Geographic Location ◽  
Social Contact ◽  
Temporal Behaviour ◽  
Fine Grained ◽  
Health Authorities ◽  
Public Health Authorities ◽  
Spatio Temporal ◽  
Media Reports ◽  
Predictive Risk ◽  
The Impact

Abstract The CoVID-19 pandemic is showing a dramatic impact across the world. To the tragedy of the loss of human lives, we must add the great uncertainty that the new coronavirus is causing to our lives. Governments and public health authorities must be able to respond this emergency by taking the appropriate decisions for minimizing the impact of the virus. In the absence of an immediate solution, governments have concentrated their efforts on adopting non-pharmaceutical interventions for restricting the mobility of people and reducing the social contact. Health authorities are publishing most of data for supporting their interventions and policies. The geographic location of the cases is a vital information with exceptional value for analysing the spatio-temporal behaviour of the virus, doing feasible to anticipate potential outbreaks and to elaborate predictive risk mapping. In fact, a great number of media reports, research papers, and web-browsers have presented the COVID-19 disease spreading by using maps. However, processing and visualization of this sort of data presents some aspects that must be carefully reviewed. Based on our experience with fine-grained and detailed data related to COVID-19 in a Spanish region, we present a bunch of mapping strategies and good practices using geospatial tools. The ultimate goal is create appropriate maps at any spatial scale while avoiding conflicts with data such as those related to patients’ privacy.

scholarly journals Impact of emergency hospital admissions on patterns of primary care prescribing: a retrospective cohort analysis of electronic records in England

2020 ◽  
Vol 70 (695) ◽  
pp. e399-e405
Author(s):  
Rachel Denholm ◽  
Richard Morris ◽  
Sarah Purdy ◽  
Rupert Payne
Keyword(s):  
Hospital Admission ◽  
Retrospective Cohort ◽  
Hospital Admissions ◽  
Cohort Analysis ◽  
Post Discharge ◽  
Emergency Hospital ◽  
Obstetrics And Gynaecology ◽  
Emergency Hospital Admission ◽  
Retrospective Cohort Analysis ◽  
The Impact

BackgroundLittle is known about the impact of hospitalisation on prescribing in UK clinical practice.AimTo investigate whether an emergency hospital admission drives increases in polypharmacy and potentially inappropriate prescriptions (PIPs).Design and settingA retrospective cohort analysis set in primary and secondary care in England.MethodChanges in number of prescriptions and PIPs following an emergency hospital admission in 2014 (at admission and 4 weeks post-discharge), and 6 months post-discharge were calculated among 37 761 adult patients. Regression models were used to investigate changes in prescribing following an admission.ResultsEmergency attendees surviving 6 months (N = 32 657) had a mean of 4.4 (standard deviation [SD] = 4.6) prescriptions before admission, and a mean of 4.7 (SD = 4.7; P<0.001) 4 weeks after discharge. Small increases (<0.5) in the number of prescriptions at 4 weeks were observed across most hospital specialties, except for surgery (−0.02; SD = 0.65) and cardiology (2.1; SD = 2.6). The amount of PIPs increased after hospitalisation; 4.0% of patients had ≥1 PIP immediately before pre-admission, increasing to 8.0% 4 weeks post-discharge. Across hospital specialties, increases in the proportion of patients with a PIP ranged from 2.1% in obstetrics and gynaecology to 8.0% in cardiology. Patients were, on average, prescribed fewer medicines at 6 months compared with 4 weeks post-discharge (mean = 4.1; SD = 4.6; P<0.001). PIPs decreased to 5.4% (n = 1751) of patients.ConclusionPerceptions that hospitalisation is a consistent factor driving rises in polypharmacy are unfounded. Increases in prescribing post-hospitalisation reflect appropriate clinical response to acute illness, whereas decreases are more likely in patients who are multimorbid, reflecting a focus on deprescribing and medicines optimisation in these individuals. Increases in PIPs remain a concern.

scholarly journals Impact of data accuracy on the evaluation of COVID-19 mitigation policies

Data & Policy ◽  
2021 ◽  
Vol 3 ◽  
Author(s):  
Michele Starnini ◽  
Alberto Aleta ◽  
Michele Tizzoni ◽  
Yamir Moreno
Keyword(s):  
Epidemiological Data ◽  
Surveillance Data ◽  
Inaccurate Data ◽  
Health Authorities ◽  
The Social ◽  
Containment Measures ◽  
Public Health Authorities ◽  
Nonpharmaceutical Interventions ◽  
The Impact ◽  
Extreme Care

Abstract Evaluating the effectiveness of nonpharmaceutical interventions (NPIs) to mitigate the COVID-19 pandemic is crucial to maximize the epidemic containment while minimizing the social and economic impact of these measures. However, this endeavor crucially relies on surveillance data publicly released by health authorities that can hide several limitations. In this article, we quantify the impact of inaccurate data on the estimation of the time-varying reproduction number $ R(t) $ , a pivotal quantity to gauge the variation of the transmissibility originated by the implementation of different NPIs. We focus on Italy and Spain, two European countries among the most severely hit by the COVID-19 pandemic. For these two countries, we highlight several biases of case-based surveillance data and temporal and spatial limitations in the data regarding the implementation of NPIs. We also demonstrate that a nonbiased estimation of $ R(t) $ could have had direct consequences on the decisions taken by the Spanish and Italian governments during the first wave of the pandemic. Our study shows that extreme care should be taken when evaluating intervention policies through publicly available epidemiological data and call for an improvement in the process of COVID-19 data collection, management, storage, and release. Better data policies will allow a more precise evaluation of the effects of containment measures, empowering public health authorities to take more informed decisions.

scholarly journals The importance of sustained compliance with physical distancing during COVID-19 vaccination rollout

2021 ◽  
Author(s):  
Alexandra Teslya ◽  
Ganna Rozhnova ◽  
Thi Mui Pham ◽  
Daphne van Wees ◽  
Hendrik Nunner ◽  
...  
Keyword(s):  
Vaccination Coverage ◽  
Vaccine Coverage ◽  
Transmission Model ◽  
Cumulative Number ◽  
Vaccination Rates ◽  
Contact Rates ◽  
Health Authorities ◽  
Public Health Authorities ◽  
Vaccination Campaigns ◽  
The Impact

Abstract Mass vaccination campaigns against SARS-CoV-2 are under way in many countries with the hope that increasing vaccination coverage will enable reducing current physical distancing measures. Compliance with these measures is waning, while more transmissible virus variants such as B.1.1.7 have emerged. Using SARS-CoV-2 transmission model we investigated the impact of the feedback between compliance, the incidence of infection, and vaccination coverage on the success of a vaccination programme in the population where waning of compliance depends on vaccine coverage. Our results suggest that the combination of fast waning compliance, slow vaccination rates, and more transmissible variants may result in a higher cumulative number of infections than in a situation without vaccination. These adverse effects can be alleviated if vaccinated individuals do not revert to pre-pandemic contact rates, and if non-vaccinated individuals remain compliant with physical distancing measures. Both require convincing, clear and appropriately targeted communication strategies by public health authorities.

scholarly journals Trends in admissions for acute respiratory infections in children: an inter-country comparison between Western Australia and England

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Hannah Moore ◽  
Tasmin Abdalla ◽  
Christopher Blyth ◽  
Ruth Gilbert ◽  
Pia Hardelid
Keyword(s):  
Western Australia ◽  
Hospital Admissions ◽  
Respiratory Infections ◽  
Laboratory Data ◽  
Primary Diagnosis ◽  
Respiratory Pathogens ◽  
Vaccination Programs ◽  
Admission Rates ◽  
Tract Infections ◽  
The Impact

ABSTRACTObjectiveAcute respiratory infections (ARI) including bronchiolitis, pneumonia and influenza are a major cause of hospital admissions in children worldwide. Linkage of administrative health datasets provides a platform to investigate temporal and seasonal trends in large populations over many years. We examined the similarities and differences in ARI admissions using linked datasets in Western Australia and England. ApproachThrough the availability of common data items in each jurisdiction, identical coding and data cleaning principles were applied to both datasets. Hospital admissions for ARI in children aged <5 years between 2000 and 2012 were identified using International Classification of Diseases diagnosis codes. Admission rates per 1000 child-years by age, gender and admission year were calculated in each jurisdiction. A total population birth cohort was available in Western Australia and the denominator was person time at risk whereas for England, all hospitalisations were used with the mid-year population as the denominator. ResultsThe overall incidence of ARI was 18.3/1000 child-years in Western Australia and 14.4/1000 in England. In both countries, the highest incidence of ARI was observed in infants (47.9/1000 child-years in Western Australia and 42.1/1000 child-years in England). Bronchiolitis was the most common primary diagnosis in infants in both countries, accounting for 79.7% of ARI admissions in Western Australia and 78.3% in England. The most common primary diagnosis in 1-4 year olds was unspecified lower respiratory tract infections in England (48.8% of ARI admissions in this age group) and pneumonia in Western Australia (43.9% of ARI admissions in 1-4-year-olds). The annual incidence rate for ARI hospitalisations declined in Western Australia from 2000 to 2006 and since remained steady. ARI admission rates increased in England throughout the study period. Admission rates across all age groups were 1.1-1.5 times higher in boys than girls in both countries. ConclusionThe availability of similar datasets in two economically similar countries in different hemispheres has afforded the opportunity to characterise and compare the epidemiology of paediatric respiratory infections over a 13 year period. Future analyses will allow us to assess differences in coding practices, seasonality and risk factors such as socio-economic deprivation and prematurity. Furthermore the availability of linked laboratory data for respiratory pathogens in each jurisdiction will allow for comparisons of pathogen-specific epidemiology and the impact of universal vaccination programs.

scholarly journals Impact of COVID-19 Pandemic on Cancer-Related Hospitalizations in Brazil

2021 ◽  
Vol 28 ◽  
pp. 107327482110387
Author(s):  
Allini Mafra da Costa ◽  
Aline L. Ribeiro ◽  
Adeylson G. Ribeiro ◽  
Andrea Gini ◽  
Citadel Cabasag ◽  
...  
Keyword(s):  
Cancer Survival ◽  
Hospital Admissions ◽  
Control Strategies ◽  
Cancer Control ◽  
Regional Level ◽  
Southeastern Brazil ◽  
Admission Rates ◽  
Monthly Average ◽  
Hospitalization Rates ◽  
The Impact

Background Alongside the SARS-CoV-2 (COVID-19) pandemic, Brazil also faces an ongoing rise in cancer burden. In 2020, there were approximately 592 000 new cancer cases and 260 000 cancer deaths. Considering the heterogeneities across Brazil, this study aimed to estimate the impact of the COVID-19 pandemic on cancer-related hospital admissions at a national and regional level. Methods The national, regional, and state-specific monthly average of cancer-related hospital admission rates per 100 000 inhabitants and 95% confidence intervals (95% CIs) were calculated from March to July (2019: pre-COVID-19; and 2020: COVID-19 period). Thematic maps were constructed to compare the rates between periods and regions. Results Cancer-related hospital admissions were reduced by 26% and 28% for clinical and surgical purposes, respectively. In Brazil, the average hospitalization rates decreased from 13.9 in 2019 to 10.2 in 2020 per 100,000 inhabitants, representing a rate difference of −3.7 (per 100,000 inhabitants; 95% CI: −3.9 to −3.5) for cancer-related (clinical) hospital admissions. Surgical hospital admissions showed a rate decline of −5.8 per 100,000 (95% CI: −6.0 to −5.5). The reduction in cancer-related admissions for the surgical procedure varies across regions ranging between −2.2 and −10.8 per 100 000 inhabitants, with the most significant decrease observed in the south and southeastern Brazil. Conclusions We observed a substantial decrease in cancer-related hospital admissions during the COVID-19 pandemic with marked differences across regions. Delays in treatment may negatively impact cancer survival in the future; hence, cancer control strategies to mitigate the impact are needed.

scholarly journals Examining trends in gun violence injuries before and during the COVID-19 pandemic across six trauma centers

2022 ◽  
Vol 7 (1) ◽  
pp. e000801
Author(s):  
Constance McGraw ◽  
Stephanie Jarvis ◽  
Matthew Carrick ◽  
Mark Lieser ◽  
Robert M Madayag ◽  
...  
Keyword(s):  
Mental Illness ◽  
Substance Use ◽  
Trauma Centers ◽  
National Guidelines ◽  
Level Of Evidence ◽  
Health Authorities ◽  
Public Health Authorities ◽  
Level I ◽  
The Impact ◽  
At Home

ObjectivesThe onset of the national stay-at-home orders accompanied by a surge in firearm sales has elevated the concerns of clinicians and public health authorities. The purpose of this study was to examine the impact of the stay-at-home orders among gunshot wound (GSW) trauma admissions.MethodsThis was a retrospective cohort study at six level I trauma centers across four states. Patients admitted after the onset of COVID-19 restrictions (March 16, 2020–June 30, 2020) were compared with those admitted during the same period in 2019. We compared (1) rate of patients with GSW and (2) characteristics of patients with GSW, by period using Χ2 tests or Fisher’s exact tests, as appropriate.ResultsThere were 6996 trauma admissions across the study period; 3707 (53%) in 2019 and 3289 (47%) in 2020. From 2019 to 2020, there was a significant increase in GSW admissions (4% vs. 6%, p=0.001); 4 weeks specifically had significant increases (March 16–March 23: 4%, April 1–April 8: 5%, April 9–April 16: 6%, and May 11–May 18: 5%). Of the 334 GSWs, there were significant increases in patients with mental illness (5% vs. 11%, p=0.03), alcohol use disorder (2% vs. 10%, p=0.003), substance use disorder (11% vs. 25%, p=0.001), and a significant decrease in mortality (14% vs. 7%, p=0.03) in 2020. No other significant differences between time periods were identified.ConclusionOur data suggest that trauma centers admitted significantly more patients with GSW following the national guidelines, including an increase in those with mental illness and substance use-related disorders. This could be attributable to the stay-at-home orders.Level of evidenceLevel III, retrospective study.

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