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10.1136/bmjopen-2020-041370

http://scihub22266oqcxt.onion/10.1136/bmjopen-2020-041370
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32988953!7523155!32988953
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suck abstract from ncbi


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pmid32988953      BMJ+Open 2020 ; 10 (9): e041370
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  • Population Health Management to identify and characterise ongoing health need for high-risk individuals shielded from COVID-19: a cross-sectional cohort study #MMPMID32988953
  • Kenward C; Pratt A; Creavin S; Wood R; Cooper JA
  • BMJ Open 2020[Sep]; 10 (9): e041370 PMID32988953show ga
  • OBJECTIVES: To use Population Health Management (PHM) methods to identify and characterise individuals at high-risk of severe COVID-19 for which shielding is required, for the purposes of managing ongoing health needs and mitigating potential shielding-induced harm. DESIGN: Individuals at 'high risk' of COVID-19 were identified using the published national 'Shielded Patient List' criteria. Individual-level information, including current chronic conditions, historical healthcare utilisation and demographic and socioeconomic status, was used for descriptive analyses of this group using PHM methods. Segmentation used k-prototypes cluster analysis. SETTING: A major healthcare system in the South West of England, for which linked primary, secondary, community and mental health data are available in a system-wide dataset. The study was performed at a time considered to be relatively early in the COVID-19 pandemic in the UK. PARTICIPANTS: 1 013 940 individuals from 78 contributing general practices. RESULTS: Compared with the groups considered at 'low' and 'moderate' risk (ie, eligible for the annual influenza vaccination), individuals at high risk were older (median age: 68 years (IQR: 55-77 years), cf 30 years (18-44 years) and 63 years (38-73 years), respectively), with more primary care/community contacts in the previous year (median contacts: 5 (2-10), cf 0 (0-2) and 2 (0-5)) and had a higher burden of comorbidity (median Charlson Score: 4 (3-6), cf 0 (0-0) and 2 (1-4)). Geospatial analyses revealed that 3.3% of rural and semi-rural residents were in the high-risk group compared with 2.91% of urban and inner-city residents (p<0.001). Segmentation uncovered six distinct clusters comprising the high-risk population, with key differentiation based on age and the presence of cancer, respiratory, and mental health conditions. CONCLUSIONS: PHM methods are useful in characterising the needs of individuals requiring shielding. Segmentation of the high-risk population identified groups with distinct characteristics that may benefit from a more tailored response from health and care providers and policy-makers.
  • |*Coronavirus Infections/epidemiology/prevention & control[MESH]
  • |*Pandemics/prevention & control[MESH]
  • |*Pneumonia, Viral/epidemiology/prevention & control[MESH]
  • |*Population Health Management[MESH]
  • |*Risk Management/methods/organization & administration[MESH]
  • |Aged[MESH]
  • |Betacoronavirus[MESH]
  • |COVID-19[MESH]
  • |Cross-Sectional Studies[MESH]
  • |Demography[MESH]
  • |England/epidemiology[MESH]
  • |Female[MESH]
  • |General Practice/statistics & numerical data[MESH]
  • |Health Information Systems/*statistics & numerical data[MESH]
  • |Humans[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Needs Assessment[MESH]
  • |Risk Assessment/*methods[MESH]
  • |Risk Factors[MESH]
  • |SARS-CoV-2[MESH]


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