COVID-19-specific Prefectural Hospital Bed Utilization Rate and In-hospital Mortality Among COVID-19 Patients Throughout the First 3 Years of the Pandemic in Japan
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- Kimura Hitomi
- Institute for Global Health Policy Research, Bureau of Global Health Cooperation, Japan Institute for Health Security Doctoral Program in Medical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba
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- Hosozawa Mariko
- Institute for Global Health Policy Research, Bureau of Global Health Cooperation, Japan Institute for Health Security
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- Taniguchi Yuta
- Institute for Global Health Policy Research, Bureau of Global Health Cooperation, Japan Institute for Health Security Department of Health Services Research, Institute of Medicine, University of Tsukuba
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- Yamagishi Kazumasa
- Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba Department of Public Health, Juntendo University Graduate School of Medicine
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- Kitajima Koji
- Center for Clinical Sciences, Japan Institute for Health Security
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- Terada Mari
- Center for Clinical Sciences, Japan Institute for Health Security Disease Control and Prevention Center, Japan Institute for Health Security
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- Asai Yusuke
- AMR Clinical Reference Center, Japan Institute for Health Security
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- Ohmagari Norio
- Disease Control and Prevention Center, Japan Institute for Health Security AMR Clinical Reference Center, Japan Institute for Health Security
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- Iso Hiroyasu
- Institute for Global Health Policy Research, Bureau of Global Health Cooperation, Japan Institute for Health Security Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba
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説明
<p>Background: We examined the association between the coronavirus disease 2019 (COVID-19)-specific prefectural bed utilization rate and in-hospital mortality during the first 3 years of the pandemic in Japan.</p><p>Methods: This nationwide study included 58,175 COVID-19 patients from the COVID-19 Registry Japan, hospitalized between May 1, 2020 and November 30, 2022. Based on the weekly COVID-19-specific bed utilization rate in each prefecture at diagnosis, patients were categorized into four groups (<25%, 25% to <50%, 50% to <75%, and ≥75%). Odds ratios (ORs) were estimated by fitting a generalized linear mixed model with prefecture as a random intercept and adjusting for covariates (age, gender, body mass index, smoking and drinking status, and comorbidities). Additional analyses according to age group, gender, and wave of the pandemic were conducted.</p><p>Results: We observed 2,312 (4.0%) all-cause in-hospital deaths. All-cause in-hospital mortality increased with higher COVID-19 bed utilization rates at diagnosis (OR for multivariable model 1.35; 95% confidence interval [CI], 1.19–1.54 for 25% to <50%; OR 1.89; 95% CI, 1.66–2.16 for 50 to <75%; OR 2.16; 95% CI, 1.80–2.58 for ≥75%; P for trend <0.0001). Stronger associations were noted among the younger population (aged <70 years: OR 3.18; 95% CI, 1.96–5.19) and during the fourth (March 1–June 30, 2021: OR 3.81; 95% CI, 2.13–6.80) and sixth pandemic waves (January 1–June 30, 2022: OR 2.67; 95% CI, 1.68–4.23).</p><p>Conclusion: Our results emphasize that preventing hospital bed shortages during outbreaks is an important public health strategy to reduce the associated mortality, particularly when new strains emerge and in younger people.</p>
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Ｊｏｕｒｎａｌ ｏｆ Ｅｐｉｄｅｍｉｏｌｏｇｙ advpub (0), 2025
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