Effectiveness of post-COVID-19 primary care attendance in improving survival in very old patients with multimorbidity:a territory-wide target trial emulation  

作　　者：Cuiling Wei Vincent Ka Chun Yan Camille Maringe Wenxin Tian Rachel Yui Ki Chu Wenlong Liu Boyan Liu Yuqi Hu Lingyue Zhou Celine Sze Ling Chui Xue Li Eric Yuk Fai Wan Ching Lung Cheung Esther Wai Yin Chan William Chi Wai Wong Ian Chi Kei Wong Francisco Tsz Tsun Lai 

机构地区：[1]Centre for Safe Medication Practice and Research,Department of Pharmacology and Pharmacy,Li Ka Shing Faculty of Medicine,The University of Hong Kong,Hong Kong,Hong Kong [2]Department of Health Services Research and Policy,Faculty of Public Health and Policy,London School of Hygiene and Tropical Medicine,London,UK [3]School of Nursing,Li Ka Shing Faculty of Medicine,The University of Hong Kong,Hong Kong,Hong Kong [4]School of Public Health,Li Ka Shing Faculty of Medicine,The University of Hong Kong,Hong Kong,Hong Kong [5]Laboratory of Data Discovery for Health(D24H),Hong Kong,Hong Kong [6]Advanced Data Analytics for Medical Science(ADAMS)Limited,Hong Kong,Hong Kong [7]Department of Medicine,School of Clinical Medicine,Li Ka Shing Faculty of Medicine,The University of Hong Kong,Hong Kong,Hong Kong [8]Department of Family Medicine and Primary Care,School of Clinical Medicine,Li Ka Shing Faculty of Medicine,The University of Hong Kong,Hong Kong,Hong Kong [9]Department of Pharmacy,The University of Hong Kong-Shenzhen Hospital,Shenzhen,People's Republic of China [10]Aston Pharmacy School,Aston University,Birmingham,UK [11]School of Pharmacy,Macao University of Science and Technology,Taipa,Macao

出　　处：《Family Medicine and Community Health》2024年第3期25-35,共11页家庭医学与社区卫生（英文）

基　　金：funded by a research grant from the Health Bureau of the Government of the Hong Kong Special Administrative Region,through the Health and Medical Research Fund Research on COVID-19(COVID19F01);supported by the Laboratory of Data Discovery for Health,funded by the AIR@InnoHK and administered by the Innovation and Technology Commission.

摘　　要：Objectives Older individuals with multimorbidity are at an elevated risk of infection and complications from COVID-19.Effectiveness of post-COVID-19 interventions or care models in reducing subsequent adverse outcomes in these individuals have rarely been examined.This study aims to examine the effectiveness of attending general outpatient within 30 days after discharge from COVID-19 on 1-year survival among older adults aged 85 years or above with multimorbidity.Design Retrospective cohort study emulating a randomised target trial using electronic health records.Setting We used data from the Hospital Authority and the Department of Health in Hong Kong,which provided comprehensive electronic health records,COVID-19 confirmed case data,population-based vaccination records and other individual characteristics for the study.Participants Adults aged 85 years or above with multimorbidity who were discharged after hospitalisation for COVID-19 between January 2020 and August 2022.Interventions Attending a general outpatient within 30 days of last COVID-19 discharge defined the exposure,compared to no outpatient visit.Main outcome measures Primary outcome was all-cause mortality within one year.Secondary outcomes included mortality from respiratory,cardiovascular and cancer causes.Results A total of 6183 eligible COVID-19 survivors were included in the analysis.The all-cause mortality rate following COVID-19 hospitalisation was lower in the general outpatient visit group(17.1 deaths per 100 person-year)compared with non-visit group(42.8 deaths per 100 person-year).After adjustment,primary care consultations within 30 days after discharge were associated with a significantly greater 1-year survival(difference in 1-year survival:11.2%,95%CI 8.1%to 14.4%).We also observed significantly better survival from respiratory diseases in the general outpatient visit group(difference in 1-year survival:6.3%,95%CI 3.5%to 8.9%).In a sensitivity analysis for different grace period lengths,we found that the earlier participants had a ge

关 键 词：MORBIDITY VISIT records 

分 类 号：R197.1[医药卫生—卫生事业管理]