Forecasting spatial, socioeconomic and demographic variation in COVID-19 health care demand in England and Wales

Verhagen, Mark D.; Brazel, David M.; Dowd, Jennifer Beam; Kashnitsky, Ilya; Mills, Melinda

doi:10.1186/s12916-020-01646-2

Cited by 55 publications

(41 citation statements)

References 9 publications

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“…Rapid shifts in ED case-mix during COVID-19 have made it difficult to match capacity with need ( 10 ). While some areas experienced massive presentation rates of infected individuals such as New York, many EDs experienced an overall reduction in visits, especially in regions where prevalence remained ( 11 ).…”

Section: Introductionmentioning

confidence: 99%

Impact of Pandemics/Epidemics on Emergency Department Utilization for Mental Health and Substance Use: A Rapid Review

et al. 2021

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Background: A prolonged COVID-19 pandemic has the potential to trigger a global mental health crisis increasing demand for mental health emergency services. We undertook a rapid review of the impact of pandemics and epidemics on emergency department utilization for mental health (MH) and substance use (SU).Objective: To rapidly synthesize available data on emergency department utilization for psychiatric concerns during COVID-19.Methods: An information specialist searched Medline, Embase, Psycinfo, CINAHL, and Scopus on June 16, 2020 and updated the search on July 24, 2020. Our search identified 803 abstracts, 7 of which were included in the review. Six articles reported on the COVID-19 pandemic and one on the SARS epidemic.Results: All studies reported a decrease in overall and MH related ED utilization during the early pandemic/epidemic. Two studies found an increase in SU related visits during the same period. No data were available for mid and late stage pandemics and the definitions for MH and SU related visits were inconsistent across studies.Conclusions: Our results suggest that COVID-19 has resulted in an initial decrease in ED visits for MH and an increase in visits for SU. Given the relative paucity of data on the subject and inconsistent analytic methods used in existing studies, there is an urgent need for investigation of pandemic-related changes in ED case-mix to inform system-level change as the pandemic continues.

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Section: Introductionmentioning

confidence: 99%

Impact of Pandemics/Epidemics on Emergency Department Utilization for Mental Health and Substance Use: A Rapid Review

et al. 2021

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“…With a rapidly aging world population and increases in disease risk factors, the existing medical and health resources are increasingly less able to meet increasing demand for health services [ 1 ]. As providers of primary health services, community-level health service personnel assume multiple responsibilities of prevention, health care, rehabilitation, health education, family planning technical services, and the diagnosis and treatment of common and frequently occurring diseases.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and associated factors of the career plateau of primary care providers in Heilongjiang, China: a cross-sectional study

Liu

et al. 2021

BMC Fam Pract

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Background Primary care providers are pillars of China’s medical and health sectors. However, due to the gap between career expectations and reality, they enter a career plateau phase through excessive pressure. This study aims to examine the prevalence and associated factors of the career plateau of primary care providers in Heilongjiang Province, China, and proposes strategies to improve and promote their career advancement. Methods Based on city-level GDP growth in the province, a questionnaire survey was conducted among 1500 primary care providers (effective response rate = 85.8%). Pearson’s chi-square analysis and binary logistic regression were used to analyse the factors associated with their career plateau. Results The prevalence rate of career plateau was 61.8% among primary care provider respondents. The factors associated with a career plateau included having a spouse (OR = 1.394, 95%CI = 1.056–1.839), working more than 40 h per week (OR = 1.473, 95%CI = 1.146–1.893); working for 11–20 years (OR = 1.607, 95%CI = 1.150–2.246); working for more than 20 years (OR = 2.818, 95%CI = 1.938–4.097); having an average monthly income of 3001–4000 yuan (OR = 1.886, 95%CI = 1.197–2.969) or 4001–5000 yuan (OR = 2.104, 95%CI = 1.256–3.524); and reporting unsatisfactory or very unsatisfactory sleep quality (OR = 1.838, 95%CI = 1.317–2.567). Conclusions Primary care providers in Heilongjiang Province face a high career plateau, with marital status, weekly working hours, number of years employed, monthly average income, and sleep quality considered associated factors. To eliminate negative factors of the career plateau, it is necessary to provide support to primary care providers in four domains: individual, organisation, society, and policy.

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“…Although our choice was driven by literature, idiosyncratic choices and partial knowledge open the possibility of omitting relevant variables. For example, unlike some existing research, 34 we have not included the availability of beds as a factor that generates supply-side pressures. The reason for this choice is that responses to the COVID-19 crisis suggest that the elasticity in the supply of beds is higher than that of the supply of workforce.…”

Section: Discussionmentioning

confidence: 99%

Measuring geographical disparities in England at the time of COVID-19: results using a composite indicator of population vulnerability

et al. 2020

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ObjectivesThe growth of COVID-19 infections in England raises questions about system vulnerability. Several factors that vary across geographies, such as age, existing disease prevalence, medical resource availability and deprivation, can trigger adverse effects on the National Health System during a pandemic. In this paper, we present data on these factors and combine them to create an index to show which areas are more exposed. This technique can help policy makers to moderate the impact of similar pandemics.DesignWe combine several sources of data, which describe specific risk factors linked with the outbreak of a respiratory pathogen, that could leave local areas vulnerable to the harmful consequences of large-scale outbreaks of contagious diseases. We combine these measures to generate an index of community-level vulnerability.Setting91 Clinical Commissioning Groups (CCGs) in England.Main outcome measuresWe merge 15 measures spatially to generate an index of community-level vulnerability. These measures cover prevalence rates of high-risk diseases; proxies for the at-risk population density; availability of staff and quality of healthcare facilities.ResultsWe find that 80% of CCGs that score in the highest quartile of vulnerability are located in the North of England (24 out of 30). Here, vulnerability stems from a faster rate of population ageing and from the widespread presence of underlying at-risk diseases. These same areas, especially the North-East Coast areas of Lancashire, also appear vulnerable to adverse shocks to healthcare supply due to tighter labour markets for healthcare personnel. Importantly, our index correlates with a measure of social deprivation, indicating that these communities suffer from long-standing lack of economic opportunities and are characterised by low public and private resource endowments.ConclusionsEvidence-based policy is crucial to mitigate the health impact of pandemics such as COVID-19. While current attention focuses on curbing rates of contagion, we introduce a vulnerability index combining data that can help policy makers identify the most vulnerable communities. We find that this index is positively correlated with COVID-19 deaths and it can thus be used to guide targeted capacity building. These results suggest that a stronger focus on deprived and vulnerable communities is needed to tackle future threats from emerging and re-emerging infectious disease.

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Forecasting spatial, socioeconomic and demographic variation in COVID-19 health care demand in England and Wales

Cited by 55 publications

References 9 publications

Impact of Pandemics/Epidemics on Emergency Department Utilization for Mental Health and Substance Use: A Rapid Review

Impact of Pandemics/Epidemics on Emergency Department Utilization for Mental Health and Substance Use: A Rapid Review

Prevalence and associated factors of the career plateau of primary care providers in Heilongjiang, China: a cross-sectional study

Measuring geographical disparities in England at the time of COVID-19: results using a composite indicator of population vulnerability

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