加州 COVID-19 疫苗公平政策:受影响社区避免的病例、住院和死亡。

IF 8.6 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Health Affairs Pub Date : 2024-05-01 DOI:10.1377/hlthaff.2023.01163
Christopher M Hoover, Emily Estus, Ada Kwan, Kristal Raymond, Tanu Sreedharan, Tomás León, Seema Jain, Priya B Shete
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引用次数: 0

摘要

2021 年 3 月,加利福尼亚州实施了一项疫苗公平政策,将 COVID-19 疫苗优先分配给以地区为基础的社会经济衡量标准--"健康场所指数"(Healthy Places Index)确定为最不利的社区。我们进行了准实验分析和反事实分析,以估计该政策对 COVID-19 疫苗接种率、病例率、住院率和死亡率的影响。在优先社区中,政策实施后疫苗接种率提高了 28.4%。此外,在条件最差的社区,该政策估计避免了 160,892 例 COVID-19 病例、10,248 例住院治疗和 679 例死亡。尽管取得了这些进展,但优先社区的 COVID-19 病例、住院人数和死亡人数所占比例仍然较高。这些估计值在敏感性分析中是可靠的,这些分析测试了优先社区与未被政策优先考虑的社区之间的可交换性、模型规格以及潜在的时间混杂因素,包括先前的感染。通过将有限的资源战略性地分配给处境最不利或受影响最严重的社区来纠正差异,可以减少 COVID-19 和其他疾病的影响,但可能无法消除健康差异。
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California's COVID-19 Vaccine Equity Policy: Cases, Hospitalizations, And Deaths Averted In Affected Communities.

In March 2021, California implemented a vaccine equity policy that prioritized COVID-19 vaccine allocation to communities identified as least advantaged by an area-based socioeconomic measure, the Healthy Places Index. We conducted quasi-experimental and counterfactual analyses to estimate the effect of this policy on COVID-19 vaccination, case, hospitalization, and death rates. Among prioritized communities, vaccination rates increased 28.4 percent after policy implementation. Furthermore, an estimated 160,892 COVID-19 cases, 10,248 hospitalizations, and 679 deaths in the least-advantaged communities were averted by the policy. Despite these improvements, the share of COVID-19 cases, hospitalizations, and deaths in prioritized communities remained elevated. These estimates were robust in sensitivity analyses that tested exchangeability between prioritized communities and those not prioritized by the policy; model specifications; and potential temporal confounders, including prior infections. Correcting for disparities by strategically allocating limited resources to the least-advantaged or most-affected communities can reduce the impacts of COVID-19 and other diseases but might not eliminate health disparities.

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来源期刊
Health Affairs
Health Affairs 医学-卫生保健
CiteScore
15.00
自引率
2.10%
发文量
246
审稿时长
3-6 weeks
期刊介绍: Health Affairs is a prestigious journal that aims to thoroughly examine significant health policy matters both domestically and globally. Our publication is committed to addressing issues that are relevant to both the private and public sectors. We are enthusiastic about inviting private and public decision-makers to contribute their innovative ideas in a publishable format. Health Affairs seeks to incorporate various perspectives from industry, labor, government, and academia, ensuring that our readers benefit from the diverse viewpoints within the healthcare field.
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