Mode of delivery and birth outcomes before and during COVID-19 –A population-based study in Ontario, Canada

PLoS ONE, Год журнала: 2024, Номер 19(5), С. e0303175 - e0303175

Опубликована: Май 10, 2024

There is lack of clarity on whether pregnancies during COVID-19 resulted in poorer mode delivery and birth outcomes Ontario, Canada. We aimed to compare (C-section), (low birthweight, preterm birth, NICU admission), health services use (HSU, hospitalizations, ED visits, physician visits) pregnant Ontario women before (pandemic periods). further stratified for pre-existing chronic diseases (asthma, eczema, allergic rhinitis, diabetes, hypertension). Deliveries (Jun 2018–Feb 2020) (Jul 2020–Mar 2022) pandemic were from administrative data. used multivariable logistic regression analyses estimate adjusted odds ratios (aOR) outcomes, negative binomial rate (aRR) HSU. compared between pre-pandemic periods. Possible interactions study periods covariates also examined. 323,359 deliveries included (50% pandemic). One 5 (18.3%) who delivered the had not received any vaccine, while one 20 (5.2%) lab-tested positive COVID-19. The C-section was 9% higher (aOR = 1.09, 95% CI: 1.08–1.11) than pre-pandemic. admission 15% 0.85, 0.82–0.87) 10% lower 0.90, 0.88–0.92), respectively, a 17% reduction visits but 16% increase (aRR 0.83, 0.81–0.84 aRR 1.16, 1.16–1.17, respectively). These aORs aRRs significantly with conditions. During pandemic, healthcare utilization, especially 0.83), before. Ensuring ongoing prenatal care may reduce risks adverse need acute pregnancy.

Язык: Английский

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Healthcare utilization trends in adults with asthma or COPD during the first year of COVID-19 pandemic in comparison to pre-pandemic: A population-based study

PLoS ONE, Год журнала: 2025, Номер 20(3), С. e0316553 - e0316553

Опубликована: Март 6, 2025

To assess how changes in outpatient services during the first year of COVID-19 pandemic were related to acute healthcare use (emergency department or hospitalizations) for individuals with asthma chronic obstructive pulmonary disease (COPD). We conducted an observational study using health administrative data Ontario (Canada) from January 2016 March 2021 on all adults diagnosed COPD. used monthly time series auto-regressive integrated moving-average (ARIMA) and pre-pandemic rates (January February 2020) calculate projected (i.e., a had not occurred) (March 2020 2021), Quasi-Poisson models two-way interaction estimate crude adjusted rate ratios. In year, COPD, visit started lower than (Mar-May 2020), returned middle (Jun-Aug then rose higher between Sep Mar 2021: observed 80,293 per 100,000 persons vs. 74,192 (95% CI: 68,926-79,868) asthma, 92,651 85,871 79,975-92,207) Acute care remained below year. While function test (PFT) both populations, decrease visits pandemic, compared pre-pandemic, was noted months highest PFT (interaction p-values < 0.0001). Despite COPD being ambulatory-care sensitive conditions, beginning associated increased use. Lower rates, suggesting that access is likely important

Язык: Английский

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Access and use of general and mental health services before and during the COVID-19 pandemic: a systematic review and meta-analysis

BMJ Open, Год журнала: 2025, Номер 15(3), С. e091342 - e091342

Опубликована: Март 1, 2025

Objectives To quantify access to health services during the COVID-19 pandemic and measure change in use between prepandemic periods a population with assessment of psychological distress or diagnosis mental disorders. Data sources We developed piloted search syntax adapted it enter following databases from 1 January 2020 31 March 2023: PubMed/MEDLINE, PsycINFO, Web Science, Epistemonikos WHO International Clinical Trials Registry Platform. reran searches end original 3 December 2024. Design systematically screened titles, abstracts full texts retrieved records. Eligibility criteria included observational studies on any populations regions, covering such as doctor visits, hospital admissions, diagnostic examinations, pharmaceutical therapies (MH) services. Only using validated scales assess disorders defined Diagnostic Statistical Manual Mental Disorders were included. extraction synthesis extracted data purposefully designed form evaluated studies’ quality Newcastle-Ottawa Scale. measured incidence rate (IR) IR ratio (IRR) periods. calculated contacts days catchment areas different used random effects DerSimonian-Laird inverse-variance model heterogeneity statistics I² τ². computed pooled IRR tested hypothesis no variation (IRR=1). Results 10 014 records examined text 580 articles. 136 primary which 44 meta-analysed. The was 2.59 contact months per 000 inhabitants (IR=2.592; 95% CI: 1.301 5.164). observed reduction 28.5% negligible differences by age group type (IRR=0.715; 0.651 0.785). significant effect sizes across (τ 2 =5.44; p<0.001 τ =0.090; p<0.001). Conclusion By considering MH, our study provides consolidated evidence quantifies pandemic. PROSPERO registration number CRD42023403778.

Язык: Английский

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Trends in all‐cause mortality and inpatient and outpatient visits for ambulatory care sensitive conditions during the first year of the COVID‐19 pandemic: A population‐based study

Journal of Hospital Medicine, Год журнала: 2022, Номер 17(9), С. 726 - 737

Опубликована: Авг. 5, 2022

Abstract Background The impact of the COVID‐19 pandemic on management ambulatory care sensitive conditions (ACSCs) remains unknown. Objectives To compare observed and expected (projected based previous years) trends in all‐cause mortality healthcare use for ACSCs first year (March 2020 to March 2021). Design, Setting Participants We conducted a population‐based study using provincial health administrative data general adul population (Ontario, Canada). Outcomes Measures Monthly mortality, hospitalizations, emergency department (ED) outpatient visit rates (per 100,000 people at‐risk) seven combined (asthma, chronic obstructive pulmonary disease, angina, congestive heart failure, hypertension, diabetes, epilepsy) during were compared with similar periods years (2016–2019) by fitting monthly time series autoregressive integrated moving‐average models. Results Compared years, increased at beginning (observed rate May 79.98 vs. projected 71.24 [66.35–76.50]) then returned June 2020—except among immigrants mental where they remained elevated. Hospitalization ED lower than throughout year: hospitalization 37.29 versus 52.07 (47.84–56.68); 92.55 134.72 (124.89–145.33). ACSC decreased initially 4299.57 5060.23 [4712.64–5433.46]) 2020.

Язык: Английский

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Outpatient Health Service Utilization Among Adults with Diabetes, Hypertension and Cardiovascular Disease During the COVID-19 Pandemic – Results of Population-Based Surveys in Germany from 2019 to 2021

Journal of Multidisciplinary Healthcare, Год журнала: 2024, Номер Volume 17, С. 675 - 687

Опубликована: Фев. 1, 2024

Purpose: Fear of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and lockdown measures may have an impact on health care utilization particularly for people with chronic diseases. We investigated changes in outpatient behavior pandemic phases among selected diseases Germany. Methods: The nationwide population-based telephone surveys German Health Update (GEDA) 2019/2020 (April 2019 to September 2020) GEDA 2021 (July December 2021) covered 4 out 7 from the pre-pandemic 4th wave. Data hypertension, diabetes major cardiovascular (CVD) past 12 months visiting a general practitioner (GP) or specialist (excluding dentist) weeks was collected using standardized questionnaire. Proportions odds ratios were derived logistic regression models adjusted age, sex, education federal states. Results: Among 27,967 participants aged ≥ 16 years, 8,449, 2,497 1,136 individuals had CVD. Participants these visited GP significantly more often than overall study population, irrespective phases. Compared phase, significant reduction specialist-visiting found first wave hypertension (34.3% vs 24.1%), (39.5% 25.5%) CVD (41.9% 25.6%). GP-visiting lower only (53.0% 46.0%). No difference compared phase. Conclusion: observed decrease at beginning not second half despite ongoing pandemic. Further studies are required examine whether temporary ambulatory affected disease management Keywords: service utilization, outpatients, SARS-CoV-2, disease, cardiometabolic diseases, diabetes, Germany

Язык: Английский

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Association of clinically significant obstructive sleep apnoea with risks of contracting COVID-19 and serious COVID-19 complications: a retrospective population-based study of health administrative data

Thorax, Год журнала: 2023, Номер 78(9), С. 933 - 941

Опубликована: Янв. 30, 2023

Rationale/objectives Despite plausible pathophysiological mechanisms, more research is needed to confirm the relationship between obstructive sleep apnoea (OSA) and risk of COVID-19 infection or COVID-19-related serious complications. Methods We conducted a retrospective population-based cohort study using provincial health administrative data (Ontario, Canada). Adults with physician-diagnosed OSA who received positive airway pressure therapy in 5 years prepandemic ( group ) were propensity score matched by baseline characteristics individuals general population at low non-OSA inverse probability treatment weighting. Weighted HRs (1) test (2) emergency department (ED) visits, hospitalisations, intensive care unit (ICU) admissions mortality, within 12 months pandemic onset, compared groups. also evaluated impact comorbid cardiometabolic chronic airways disease. Results identified 324 029 4 588 200 group. Compared group, those greater hazard testing for (HR=1.17, 95% CI 1.13 1.21), having ED visit (HR=1.62, 1.51 1.73), hospitalisation (HR=1.50, 1.37 1.65) ICU admission (HR=1.53, 1.27 1.84). 30-day mortality was not different (HR=0.98, 0.82 1.16). found that disease but conditions increased hazards outcomes, including mortality. Conclusion In this large study, we demonstrated recent diagnosis requiring associated an complications, particularly co-existing

Язык: Английский

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Impact of COVID-19 Pandemic on Chronic Obstructive Pulmonary Disease Healthcare Use, Exacerbations, and Mortality: A Population Study

Annals of the American Thoracic Society, Год журнала: 2024, Номер 21(9), С. 1281 - 1288

Опубликована: Май 31, 2024

Rationale: Existing work suggests that patients with chronic obstructive pulmonary disease (pwCOPD) presented less frequently to the emergency department and were likely be hospitalized during coronavirus (COVID-19) pandemic, but it is unclear if this was due improved health management or increased barriers and/or avoidance of care. Objectives: The objective study determine impact pandemic on inpatient outpatient healthcare use, incidence, mortality rates in pwCOPD. Methods: A retrospective population-based analysis using linked administrative datasets from Alberta, Canada 18 months before after March 12, 2020 conducted measure hospitalization, visits, COPD exacerbations these time periods. Mortality data also analyzed versus taking confirmed COVID-19 infection within 30 days into account. Subgroup based exacerbation risk stratification undertaken use differed risk. Finally, sex-based completed. Results: Hospitalization visits treatment for acute dropped, whereas total including both virtual person, rate even adjusting COVID-19-associated deaths. Sex-based subgroup showed a greater drop care females, rise seen sexes, men experiencing than women. Conclusions: Overall, pwCOPD accessed resources which may have contributed non-COVID-19 all-cause mortality.

Язык: Английский

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Diabetes care practices and outcomes in 40.000 children and adolescents with type 1 diabetes from the SWEET registry during the COVID-19 pandemic

Diabetes Research and Clinical Practice, Год журнала: 2023, Номер 202, С. 110809 - 110809

Опубликована: Июнь 27, 2023

This study aimed to provide a global insight into initiatives in type 1 diabetes care driven by the COVID-19 pandemic and associations with glycemic outcomes.An online questionnaire regarding before during was sent all centers (n = 97, 66,985 youth diabetes) active SWEET registry. Eighty-two responded, 70 (42,798 had available data (from individuals duration >3 months, aged ≤21 years) for 4 years from 2018 2021. Statistical models were adjusted, among others, technology use.Sixty-five provided telemedicine COVID-19. Among those naive 22), four continued only face-to-face visits. Centers that transitioned partially 32) showed steady increase HbA1c between 2021 (p < 0.001). Those mainly 33 %) improved compared 0.001).Changes of delivery significant shortly after outbreak 2 follow-up. The association appeared independent concomitant use diabetes.

Язык: Английский

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Health care utilization and mortality for people with epilepsy during COVID‐19: A population study

Epilepsia, Год журнала: 2024, Номер 65(5), С. 1394 - 1405

Опубликована: Март 5, 2024

Abstract Objective This study was undertaken to characterize changes in health care utilization and mortality for people with epilepsy (PWE) during the COVID‐19 pandemic. Methods We performed a retrospective using linked, individual‐level, population‐scale anonymized data from Secure Anonymised Information Linkage databank. identified PWE living Wales “pandemic period” (January 1, 2020–June 30, 2021) “prepandemic” period 2016–December 31, 2019). compared prepandemic utilization, status epilepticus, rates corresponding pandemic without (PWOE). subgroup analyses on children (<18 years old), older (>65 those intellectual disability, most deprived areas. used Poisson models calculate adjusted rate ratios (RRs). Results 27 279 who had significantly higher of hospital (50.3 visits/1000 patient months), emergency department (55.7), outpatient attendance (172.4) when PWOE (corresponding figures: 25.7, 25.2, 87.0) period. Hospital epilepsy‐related admissions, attendances all reduced (and subgroups) RRs [95% confidence intervals (CIs)] versus periods were .70 [.69–.72], .77 [.73–.81], .78 [.77–.79], .80 [.79–.81]. The also PWOE. New diagnosis decreased (2.3/100 000/month cf. 3.1/100 000/month, RR = .73, 95% CI .68–.78). Both all‐cause deaths recorded death certificate increased (RR 1.07, .997–1.145 2.44, 2.12–2.81). When removing COVID deaths, .88 (95% .81–.95) 1.29 1.08–1.53). Status epilepticus did not change .95, .78–1.15). Significance All‐cause non‐COVID increase but associated longer term effects decrease new diagnoses need further research.

Язык: Английский

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Disparities by Race and Ethnicity in Inpatient Hospitalizations Among Autistic Adults

Journal of Autism and Developmental Disorders, Год журнала: 2023, Номер 54(5), С. 1672 - 1679

Опубликована: Фев. 9, 2023

Язык: Английский

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