影响爱尔兰 COVID-19 大流行期间就医可能性的因素:对未来的启示

Padraig Buggy, Mary Joyce, Ivan J. Perry, Mary R. Cahill
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Poisson regression analyses were conducted to estimate risk ratios with robust variance estimation of the association between selected demographic and self-reported health factors and the risk of avoiding G.P. and hospital-based healthcare. Results Of the 969 participants, 152 (15.7%) deliberately avoided contacting their G.P. about non COVID-19 related concerns while 81 (8.4%) reported avoiding hospitals. Three groups, women (Rate Ratio (RR): 1.75, 95% Confidence Interval (CI): 1.28 – 2.40), individuals who reported experiencing an adverse life event within the last 3 months (RR: 1.79, 95% CI: 1.33 – 2.40), and those at an increased risk of infection (RR: 1.65, 95% CI: 1.06 – 2.58) were more likely to avoid contact with their G.P. Individuals at a higher risk of avoiding hospital-based care were those aged 50 – 59 years (RR: 2.27, 95% CI: 1.03 – 4.98) and 70 years+ (RR: 2.73, 95% CI: 1.24 – 6.01), individuals at an increased risk of infection (RR: 2.07, 95% CI: 1.20 – 3.56), smokers (RR: 1.68, 95% CI: 1.02 – 2.77) and those who agreed they were “likely to catch COVID-19” (RR: 2.80, 95% CI: 1.25 – 6.25). 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摘要

背景 在冠状病毒病(COVID-19)第一波大流行期间实施的公共卫生措施,包括旅行限制和物理距离,可能会影响人们的就医行为。识别就医障碍非常重要,尤其是对弱势群体而言。方法 在 2020 年 5 月和 6 月第一次放宽 COVID-19 限制期间,通过具有全国代表性的横断面电话调查收集数据。我们对数据集进行了二次数据分析,以研究影响个人避免接受全科医生(G.P.)和医院护理的因素。通过泊松回归分析,对选定的人口统计学因素和自我报告的健康因素与避免接受全科医生和医院医疗服务的风险之间的关系进行了风险比估算和稳健方差估算。结果 在969名参与者中,有152人(15.7%)故意避免就与COVID-19无关的问题与他们的全科医生联系,而81人(8.4%)报告说避免去医院。三个组别中,女性(比率比 (RR):1.75,95% 置信区间 (CI):1.28 - 2.40)、报告在过去 3 个月内经历过不良生活事件的人群(RR:1.79,95% CI:1.33 - 2.40)和感染风险较高的人群(RR:1.65,95% CI:1.06 - 2.58)更有可能避免与他们的普通医生联系。年龄在 50 - 59 岁(RR:2.27,95% CI:1.03 - 4.98)和 70 岁以上(RR:2.73,95% CI:1.24 - 6.01)、感染风险较高的人(RR:2.07,95% CI:1.20 - 3.56)、吸烟者(RR:1.68,95% CI:1.02 - 2.77)和认为自己 "可能感染 COVID-19 "的人(RR:2.80,95% CI:1.25 - 6.25)。结论 这些发现强调了在大流行期间开展有关获得医疗保健服务的公共卫生意识和教育的重要性,并应在未来的大流行准备工作中加以考虑。
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Factors influencing the likelihood of accessing healthcare during the COVID-19 pandemic in Ireland: lessons for the future
Background Implementation of public health measures during the first wave of the coronavirus disease (COVID-19) pandemic, including travel restrictions and physical distancing, may have impacted population behaviour in seeking medical care. Identifying barriers to accessing healthcare is important, especially for vulnerable groups. Methods Data were collected through a nationally representative cross-sectional telephone survey during the first period of easing of COVID-19 restrictions in May and June 2020. Secondary data analysis of the dataset was carried out to examine the factors influencing the likelihood of individuals avoiding General Practitioner (G.P.) and hospital-based care. Poisson regression analyses were conducted to estimate risk ratios with robust variance estimation of the association between selected demographic and self-reported health factors and the risk of avoiding G.P. and hospital-based healthcare. Results Of the 969 participants, 152 (15.7%) deliberately avoided contacting their G.P. about non COVID-19 related concerns while 81 (8.4%) reported avoiding hospitals. Three groups, women (Rate Ratio (RR): 1.75, 95% Confidence Interval (CI): 1.28 – 2.40), individuals who reported experiencing an adverse life event within the last 3 months (RR: 1.79, 95% CI: 1.33 – 2.40), and those at an increased risk of infection (RR: 1.65, 95% CI: 1.06 – 2.58) were more likely to avoid contact with their G.P. Individuals at a higher risk of avoiding hospital-based care were those aged 50 – 59 years (RR: 2.27, 95% CI: 1.03 – 4.98) and 70 years+ (RR: 2.73, 95% CI: 1.24 – 6.01), individuals at an increased risk of infection (RR: 2.07, 95% CI: 1.20 – 3.56), smokers (RR: 1.68, 95% CI: 1.02 – 2.77) and those who agreed they were “likely to catch COVID-19” (RR: 2.80, 95% CI: 1.25 – 6.25). Conclusion These findings highlight the importance of public health awareness and education regarding accessing healthcare during a pandemic and should be considered in future pandemic preparedness.
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