背景:与COVID-19大流行相关的公共卫生措施可能间接影响了其他健康结果,比如老年人跌倒。这项研究的目的是研究安大略省COVID-19大流行之前和期间老年人与秋季相关的住院和急诊科就诊的趋势,加拿大。
方法:我们从加拿大健康信息研究所数据库获得了2015年至2022年安大略省65岁及以上成年人的跌倒相关住院(N=301,945)和急诊科就诊(N=1,150,829)数据。跌倒相关伤害是使用国际疾病分类获得的,第10版,加拿大代码。使用中断的时间序列分析来模拟大流行之前(2015年1月6日至2020年3月16日)和期间(2020年3月17日至2022年12月26日)每周与秋季相关的住院和急诊科就诊的变化。
结果:调整季节性和人口变化后,与跌倒相关的住院率下降8%[相对发生率(RR)=0.92,95%置信区间(CI):0.85,1.00],与跌倒相关的急诊就诊率下降23%(RR=0.77,95CI:0.59,1.00)。其次是大流行期间两种结果的增加趋势。
结论:在大流行发作后立即住院和急诊就诊人数突然减少后,与跌倒相关的住院和急诊科就诊人数一直在稳步增长,并接近大流行前的水平。进一步的研究探索促成这些趋势的因素可能为未来的突发公共卫生事件政策提供信息,以平衡限制疾病在这一人群中的传播,同时支持身体,心理,和这个弱势群体的社会需求。
BACKGROUND: The public health measures associated with the COVID-19 pandemic may have indirectly impacted other health outcomes, such as falls among older adults. The purpose of this study was to examine trends in fall-related hospitalizations and emergency department visits among older adults before and during the COVID-19 pandemic in Ontario, Canada.
METHODS: We obtained fall-related hospitalizations (N = 301,945) and emergency department visit (N = 1,150,829) data from the Canadian Institute for Health Information databases from 2015 to 2022 for adults ages 65 and older in Ontario. Fall-related injuries were obtained using International Classification of Diseases, 10th edition, Canada codes. An interrupted time series analysis was used to model the change in weekly fall-related hospitalizations and emergency department visits before (January 6, 2015-March 16, 2020) and during (March 17, 2020-December 26, 2022) the pandemic.
RESULTS: After adjusting for seasonality and population changes, an 8% decrease in fall-related hospitalizations [Relative Rate (RR) = 0.92, 95% Confidence Interval (CI): 0.85, 1.00] and a 23% decrease in fall-related emergency department visits (RR = 0.77, 95%CI: 0.59, 1.00) were observed immediately following the onset of the pandemic, followed by increasing trends during the pandemic for both outcomes.
CONCLUSIONS: Following an abrupt decrease in hospitalizations and emergency department visits immediately following the onset of the pandemic, fall-related hospitalizations and emergency department visits have been increasing steadily and are approaching pre-pandemic levels. Further research exploring the factors contributing to these trends may inform future policies for public health emergencies that balance limiting the spread of disease among this population while supporting the physical, psychological, and social needs of this vulnerable group.