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- Pires, SM, et al.
(författare)
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Burden of Disease of COVID-19: Strengthening the Collaboration for National Studies
- 2022
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Ingår i: Frontiers in public health. - : Frontiers Media SA. - 2296-2565. ; 10, s. 907012-
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Tidskriftsartikel (refereegranskat)abstract
- Quantifying the combined impact of morbidity and mortality is a key enabler to assessing the impact of COVID-19 across countries and within countries relative to other diseases, regions, or demographics. Differences in methods, data sources, and definitions of mortality due to COVID-19 may hamper comparisons. We describe efforts to support countries in estimating the national-level burden of COVID-19 using disability-adjusted life years.MethodsThe European Burden of Disease Network developed a consensus methodology, as well as a range of capacity-building activities to support burden of COVID-19 studies. These activities have supported 11 national studies so far, with study periods between January 2020 and December 2021.ResultsNational studies dealt with various data gaps and different assumptions were made to face knowledge gaps. Still, they delivered broadly comparable results that allow for interpretation of consistencies, as well as differences in the quantified direct health impact of the pandemic.DiscussionHarmonized efforts and methodologies have allowed for comparable estimates and communication of results. Future studies should evaluate the impact of interventions, and unravel the indirect health impact of the COVID-19 crisis.
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- Baravelli, C. M., et al.
(författare)
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Subnational inequalities in YLLs and associated socioeconomic factors : a disease burden study
- 2023
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Ingår i: European Journal of Public Health. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 33:Suppl. 2, s. ii142-ii143
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Health inequalities are an unjust and avoidable problem. Thiss tudy examines subnational geographical inequalities in all-cause years of life lost (YLLs) and the association of socioeconomic factors in pre-coronavirus European Economic Area (EEA) countries.Methods: In this ecological study complimented with a longitudinal analysis, demographic and socioeconomic data for 1390 small regions and 285 basic regions of 32 EEA countries were extracted from Eurostat. Age-standardised YLL rates per 100,000 population were estimated from 2009 to 2019 based on methods from the Global Burden of Disease Study. Inequalities were assessed using the Gini coefficient (GC) and slope index of inequality (SII). The association between socioeconomic factors by YLLs were assessed using negative binomial mixed models in 2019.Findings: Over the period 2009-2019, YLLs have decreased in almost all subnational regions. The GC of YLLs across EEA regions was 14% for females (95% CI = 135 to 146%) and 17% for males (CI = 161 to 175%). Greece (GC = 101%, CI = 78 to 25%) and Belgium (GC = 108%, CI = 95 to 120%) had the highest relative inequalities in YLLs for women and men, respectively. Subnational regions with the lowest income (incident rate ratio (IRR) = 139, CI = 123 to 158) and levels of educational attainment (IRRfemales = 119, CI = 113 to 126; IRRmales = 122, CI = 116 to 128), and highest poverty risk (IRR = 118, CI = 112 to 125) were associated with increased YLLs, with stronger associations observed in Central and Eastern Europe.Interpretation: Differences in YLLs remain within and between EEA countries and are associated with socioeconomic factors. This evidence can assist stakeholders in addressing specific health inequities to improve overall disease burden within the EEA.Key messages:The study highlights the need for public health policies targeted at the subnational level to reduce health inequalities in the EEA.The study describes the effect of existing public health policies targeting socioeconomic factors.
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- Nematswerani, N., et al.
(författare)
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Understanding the impact of the COVID-19 pandemic on healthcare services for adults during three waves of COVID-19 infections: A South African private sector experience
- 2023
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Ingår i: SAMJ SOUTH AFRICAN MEDICAL JOURNAL. - 0256-9574 .- 2078-5135. ; 113:4, s. 1156-1164
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Tidskriftsartikel (refereegranskat)abstract
- Background. Since the onset of the COVID-19 pandemic, healthcare resources have been repurposed to focus on COVID-19. Resource reallocation and restrictions to movement that affected general access to care may have inadvertently resulted in undue disruptions in the continuum of care for patients requiring non-COVID-19 healthcare services. Objectives. To describe the change in pattern of health service use in the South African (SA) private sector. Methods. We conducted a retrospective study of a nationwide cohort of privately insured individuals. An analysis of claims data was performed for non-COVID-19 related healthcare services provided from April 2020 to December 2020 (year 1 of COVID-19) and April 2021 to December 2021 (year 2 of COVID-19) relative to the same period in 2019 prior to the COVID-19 pandemic in SA. Over and above plotting the monthly trends, we tested for statistical significance of the changes using a Wilcoxon test given the non-normality of all the outcomes. Results. Between April and December 2020, relative to the same period in 2021, and also relative to the same period in 2019, we found a 31.9% (p<0.01) and a 16.6% (p<0.01) reduction in emergency room visits, respectively; a 35.9% (p<0.01) and 20.5% (p<0.01) reduction in medical hospital admissions; a 27.4% (p=0.01) and 13.0% (p=0.03) reduction in surgical hospital admissions; a 14.5% (p<0.01) and 4.1% (p=0.16) reduction in face-to-face general practitioner consultations for chronic members; a 24.9% (p=0.06) and 5.2% (p=0.54) reduction in mammography for female members; a 23.4% (p=0.03) and 10.8% (p=0.09) reduction in Pap smear screenings for female members; a 16.5% (p=0.08) and 12.1% (p=0.27) reduction in colorectal cancer registrations and an 18.2% (p=0.08) and 8.9% (p=0.07) decrease in all oncology diagnoses. Uptake of telehealth services throughout the healthcare delivery system increased by 5 708% in 2020 compared with 2019, and 36.1% for 2021 compared with 2020. Conclusion. A significant reduction in emergency room visits, hospital admissions and utilisation of primary care services was observed since the start of the pandemic. Further research is required to understand if there are long-term consequences of delayed care. An increase in the use of digital consultations was observed. Research on their acceptability and effectiveness may open new modalities of care, which may have cost- and time-saving benefits.
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