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Impact of the local care environment and social characteristics on aggregated hospital fatality rate from COVID-19 in France: a nationwide observational study

OBJECTIVES: We aimed to investigate possible differences in the aggregated hospital fatality rate from coronavirus disease 2019 (COVID-19) in France at the early phase of the outbreak and to determine whether factors related to population or healthcare supply before the pandemic could be associated...

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Autores principales: Zeitoun, J.-D., Faron, M., Lefèvre, J.H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Royal Society for Public Health. Published by Elsevier Ltd. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7547603/
https://www.ncbi.nlm.nih.gov/pubmed/33197731
http://dx.doi.org/10.1016/j.puhe.2020.09.015
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author Zeitoun, J.-D.
Faron, M.
Lefèvre, J.H.
author_facet Zeitoun, J.-D.
Faron, M.
Lefèvre, J.H.
author_sort Zeitoun, J.-D.
collection PubMed
description OBJECTIVES: We aimed to investigate possible differences in the aggregated hospital fatality rate from coronavirus disease 2019 (COVID-19) in France at the early phase of the outbreak and to determine whether factors related to population or healthcare supply before the pandemic could be associated with outcome differences. STUDY DESIGN: This is a nationwide observational study including all French hospitals from January 24, 2020, to April 11, 2020. METHODS: We analyzed the aggregated hospital fatality rate. A Poisson regression was performed to investigate associations between characteristics pertaining to populational health, socio-economic context and local healthcare supply at baseline, and the chosen outcome. RESULTS: On April 11, 2020, a total number of 30,960 patients were hospitalized among the 3046 French healthcare facilities, including 6832 patients in the intensive care unit (ICU). A total of 8581 deaths due to COVID-19 had been recorded, with a median mortality rate per 10,000 people per department of 0.53 (interquartile range: 0.29–1.90). There were significant variations between the 95 French departments even after adjusting for outbreak inception (P < 0.001). After multivariable analysis, four factors were independently associated with a significantly higher aggregated hospital fatality rate: a higher ICU capacity at baseline (estimate = 1.47; P = 0.00791), a lower density of general practitioners (estimate = 0.95; P = 0.0205), a lower fraction of activity from the for-profit private sector (estimate = 0.99; P < 0.001), and the ratio of people older than 75 years (estimate = 0.91; P = 0.0023). CONCLUSIONS: The aggregated hospital fatality rate from COVID-19 in France seems to vary among geographic areas, with some factors pertaining to local healthcare supply being associated with the outcome.
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spelling pubmed-75476032020-10-13 Impact of the local care environment and social characteristics on aggregated hospital fatality rate from COVID-19 in France: a nationwide observational study Zeitoun, J.-D. Faron, M. Lefèvre, J.H. Public Health Original Research OBJECTIVES: We aimed to investigate possible differences in the aggregated hospital fatality rate from coronavirus disease 2019 (COVID-19) in France at the early phase of the outbreak and to determine whether factors related to population or healthcare supply before the pandemic could be associated with outcome differences. STUDY DESIGN: This is a nationwide observational study including all French hospitals from January 24, 2020, to April 11, 2020. METHODS: We analyzed the aggregated hospital fatality rate. A Poisson regression was performed to investigate associations between characteristics pertaining to populational health, socio-economic context and local healthcare supply at baseline, and the chosen outcome. RESULTS: On April 11, 2020, a total number of 30,960 patients were hospitalized among the 3046 French healthcare facilities, including 6832 patients in the intensive care unit (ICU). A total of 8581 deaths due to COVID-19 had been recorded, with a median mortality rate per 10,000 people per department of 0.53 (interquartile range: 0.29–1.90). There were significant variations between the 95 French departments even after adjusting for outbreak inception (P < 0.001). After multivariable analysis, four factors were independently associated with a significantly higher aggregated hospital fatality rate: a higher ICU capacity at baseline (estimate = 1.47; P = 0.00791), a lower density of general practitioners (estimate = 0.95; P = 0.0205), a lower fraction of activity from the for-profit private sector (estimate = 0.99; P < 0.001), and the ratio of people older than 75 years (estimate = 0.91; P = 0.0023). CONCLUSIONS: The aggregated hospital fatality rate from COVID-19 in France seems to vary among geographic areas, with some factors pertaining to local healthcare supply being associated with the outcome. The Royal Society for Public Health. Published by Elsevier Ltd. 2020-12 2020-10-10 /pmc/articles/PMC7547603/ /pubmed/33197731 http://dx.doi.org/10.1016/j.puhe.2020.09.015 Text en © 2020 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Original Research
Zeitoun, J.-D.
Faron, M.
Lefèvre, J.H.
Impact of the local care environment and social characteristics on aggregated hospital fatality rate from COVID-19 in France: a nationwide observational study
title Impact of the local care environment and social characteristics on aggregated hospital fatality rate from COVID-19 in France: a nationwide observational study
title_full Impact of the local care environment and social characteristics on aggregated hospital fatality rate from COVID-19 in France: a nationwide observational study
title_fullStr Impact of the local care environment and social characteristics on aggregated hospital fatality rate from COVID-19 in France: a nationwide observational study
title_full_unstemmed Impact of the local care environment and social characteristics on aggregated hospital fatality rate from COVID-19 in France: a nationwide observational study
title_short Impact of the local care environment and social characteristics on aggregated hospital fatality rate from COVID-19 in France: a nationwide observational study
title_sort impact of the local care environment and social characteristics on aggregated hospital fatality rate from covid-19 in france: a nationwide observational study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7547603/
https://www.ncbi.nlm.nih.gov/pubmed/33197731
http://dx.doi.org/10.1016/j.puhe.2020.09.015
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