Community-setting pneumonia-associated hospitalizations by level of urbanization—New York City versus other areas of New York State, 2010–2014

Autor: Chaorui C. Huang, Neil W. Schluger, Neil M. Vora, David E. Lucero, Demetre Daskalakis, Gretchen M. Culp, Rachel E. Corrado, Sungwoo Lim, Katherine Whittemore, Melody V. Wu
Rok vydání: 2020
Předmět:
Male
Rural Population
Urban Population
Pulmonology
Nosocomial Infections
Social Sciences
Geographical locations
Medical Conditions
Medicine and Health Sciences
Public and Occupational Health
Young adult
Geographic Areas
Aged
80 and over
education.field_of_study
Multidisciplinary
Geography
Mortality rate
Middle Aged
Socioeconomic Aspects of Health
Community-Acquired Infections
Hospitalization
Infectious Diseases
Medicine
Female
Research Article
Urban Areas
Adult
Science
Chronic Obstructive Pulmonary Disease
Population
New York
Human Geography
Urban Geography
Young Adult
Urbanization
Influenza
Human
medicine
Humans
Mortality
education
Poverty
Aged
business.industry
Pneumonia
medicine.disease
Rural Areas
United States
Confidence interval
Health Care
North America
Earth Sciences
New York City
People and places
Rural area
business
Demography
Zdroj: PLoS ONE
PLoS ONE, Vol 15, Iss 12, p e0244367 (2020)
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0244367
Popis: Background New York City (NYC) reported a higher pneumonia and influenza death rate than the rest of New York State during 2010–2014. Most NYC pneumonia and influenza deaths are attributed to pneumonia caused by infection acquired in the community, and these deaths typically occur in hospitals. Methods We identified hospitalizations of New York State residents aged ≥20 years discharged from New York State hospitals during 2010–2014 with a principal diagnosis of community-setting pneumonia or a secondary diagnosis of community-setting pneumonia if the principal diagnosis was respiratory failure or sepsis. We examined mean annual age-adjusted community-setting pneumonia-associated hospitalization (CSPAH) rates and proportion of CSPAH with in-hospital death, overall and by sociodemographic group, and produced a multivariable negative binomial model to assess hospitalization rate ratios. Results Compared with non-NYC urban, suburban, and rural areas of New York State, NYC had the highest mean annual age-adjusted CSPAH rate at 475.3 per 100,000 population and the highest percentage of CSPAH with in-hospital death at 13.7%. NYC also had the highest proportion of CSPAH patients residing in higher-poverty-level areas. Adjusting for age, sex, and area-based poverty, NYC residents experienced 1.3 (95% confidence interval [CI], 1.2–1.4), non-NYC urban residents 1.4 (95% CI, 1.3–1.6), and suburban residents 1.2 (95% CI, 1.1–1.3) times the rate of CSPAH than rural residents. Conclusions In New York State, NYC as well as other urban areas and suburban areas had higher rates of CSPAH than rural areas. Further research is needed into drivers of CSPAH deaths, which may be associated with poverty.
Databáze: OpenAIRE
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