PDF(Pubmed)
Abstract：
UNASSIGNED: Data modernization efforts to strengthen surveillance capacity could help assess trends in use of preventive services and diagnoses of new chronic disease during the COVID-19 pandemic, which broadly disrupted health care access.
UNASSIGNED: This cross-sectional study examined electronic health record data from US adults aged 21 to 79 years in a large national research network (PCORnet), to describe use of 8 preventive health services (N = 30,783,825 patients) and new diagnoses of 9 chronic diseases (N = 31,588,222 patients) during 2018 through 2022. Joinpoint regression assessed significant trends, and health debt was calculated comparing 2020 through 2022 volume to prepandemic (2018 and 2019) levels.
UNASSIGNED: From 2018 to 2022, use of some preventive services increased (hemoglobin A1c and lung computed tomography, both P < .05), others remained consistent (lipid testing, wellness visits, mammograms, Papanicolaou tests or human papillomavirus tests, stool-based screening), and colonoscopies or sigmoidoscopies declined (P < .01). Annual new chronic disease diagnoses were mostly stable (6% hypertension; 4% to 5% cholesterol; 4% diabetes; 1% colonic adenoma; 0.1% colorectal cancer; among women, 0.5% breast cancer), although some declined (lung cancer, cervical intraepithelial neoplasia or carcinoma in situ, cervical cancer, all P < .05). The pandemic resulted in health debt, because use of most preventive services and new diagnoses of chronic disease were less than expected during 2020; these partially rebounded in subsequent years. Colorectal screening and colonic adenoma detection by age group aligned with screening recommendation age changes during this period.
UNASSIGNED: Among over 30 million patients receiving care during 2018 through 2022, use of preventive services and new diagnoses of chronic disease declined in 2020 and then rebounded, with some remaining health debt. These data highlight opportunities to augment traditional surveillance with EHR-based data.
UNASSIGNED: This cross-sectional study examined electronic health record data from US adults aged 21 to 79 years in a large national research network (PCORnet), to describe use of 8 preventive health services (N = 30,783,825 patients) and new diagnoses of 9 chronic diseases (N = 31,588,222 patients) during 2018 through 2022. Joinpoint regression assessed significant trends, and health debt was calculated comparing 2020 through 2022 volume to prepandemic (2018 and 2019) levels.
UNASSIGNED: From 2018 to 2022, use of some preventive services increased (hemoglobin A1c and lung computed tomography, both P < .05), others remained consistent (lipid testing, wellness visits, mammograms, Papanicolaou tests or human papillomavirus tests, stool-based screening), and colonoscopies or sigmoidoscopies declined (P < .01). Annual new chronic disease diagnoses were mostly stable (6% hypertension; 4% to 5% cholesterol; 4% diabetes; 1% colonic adenoma; 0.1% colorectal cancer; among women, 0.5% breast cancer), although some declined (lung cancer, cervical intraepithelial neoplasia or carcinoma in situ, cervical cancer, all P < .05). The pandemic resulted in health debt, because use of most preventive services and new diagnoses of chronic disease were less than expected during 2020; these partially rebounded in subsequent years. Colorectal screening and colonic adenoma detection by age group aligned with screening recommendation age changes during this period.
UNASSIGNED: Among over 30 million patients receiving care during 2018 through 2022, use of preventive services and new diagnoses of chronic disease declined in 2020 and then rebounded, with some remaining health debt. These data highlight opportunities to augment traditional surveillance with EHR-based data.
摘要：
■加强监测能力的数据现代化努力可以帮助评估在COVID-19大流行期间使用预防服务和诊断新的慢性病的趋势，这广泛扰乱了医疗保健的获取。
■这项横断面研究在大型国家研究网络（PCORnet）中检查了来自21至79岁美国成年人的电子健康记录数据，描述2018年至2022年期间8项预防性卫生服务(N=30,783,825名患者)和9项慢性疾病(N=31,588,222名患者)的新诊断。Joinpoint回归评估了显著的趋势，健康债务的计算是将2020年至2022年的交易量与流行病(2018年和2019年)水平进行比较。
■从2018年到2022年，一些预防性服务的使用增加（血红蛋白A1c和肺部计算机断层扫描，两者P<.05)，其他人保持一致(脂质测试，健康访问，乳房X线照片,巴氏试验或人乳头瘤病毒试验，基于粪便的筛查)，结肠镜或乙状结肠镜检查下降（P<0.01）。每年新的慢性疾病诊断大多是稳定的（6％高血压；4％至5％胆固醇；4％糖尿病；1％结肠腺瘤；0.1％结直肠癌；在女性中，0.5%乳腺癌)，虽然有些下降(肺癌，宫颈上皮内瘤变或原位癌，宫颈癌,所有P<.05)。大流行导致了健康债务，因为大多数预防性服务的使用和慢性疾病的新诊断在2020年少于预期;这些在随后的几年中部分反弹。按年龄组进行的结肠直肠筛查和结肠腺瘤检测与在此期间的筛查推荐年龄变化相一致。
■在2018年至2022年期间接受护理的3000多万患者中，预防服务和慢性病新诊断的使用在2020年下降，然后反弹。还有一些剩余的健康债务。这些数据凸显了利用基于EHR的数据增强传统监测的机会。
■这项横断面研究在大型国家研究网络（PCORnet）中检查了来自21至79岁美国成年人的电子健康记录数据，描述2018年至2022年期间8项预防性卫生服务(N=30,783,825名患者)和9项慢性疾病(N=31,588,222名患者)的新诊断。Joinpoint回归评估了显著的趋势，健康债务的计算是将2020年至2022年的交易量与流行病(2018年和2019年)水平进行比较。
■从2018年到2022年，一些预防性服务的使用增加（血红蛋白A1c和肺部计算机断层扫描，两者P<.05)，其他人保持一致(脂质测试，健康访问，乳房X线照片,巴氏试验或人乳头瘤病毒试验，基于粪便的筛查)，结肠镜或乙状结肠镜检查下降（P<0.01）。每年新的慢性疾病诊断大多是稳定的（6％高血压；4％至5％胆固醇；4％糖尿病；1％结肠腺瘤；0.1％结直肠癌；在女性中，0.5%乳腺癌)，虽然有些下降(肺癌，宫颈上皮内瘤变或原位癌，宫颈癌,所有P<.05)。大流行导致了健康债务，因为大多数预防性服务的使用和慢性疾病的新诊断在2020年少于预期;这些在随后的几年中部分反弹。按年龄组进行的结肠直肠筛查和结肠腺瘤检测与在此期间的筛查推荐年龄变化相一致。
■在2018年至2022年期间接受护理的3000多万患者中，预防服务和慢性病新诊断的使用在2020年下降，然后反弹。还有一些剩余的健康债务。这些数据凸显了利用基于EHR的数据增强传统监测的机会。
