Health and healthcare variables associated with Italy's excess mortality during the first wave of the COVID-19 pandemic: An ecological study

  1. Alessandra Buja
  2. Matteo Paganini
  3. Riccardo Fusinato
  4. Claudia Cozzolino
  5. Silvia Cocchio
  6. Manuela Scioni
  7. Vincenzo Rebba
  8. Vincenzo Baldo
  9. Giovanna Boccuzzo

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Abstract

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  1. Version published to 10.1016/j.healthpol.2022.03.002
  2. ScreenIT

    SciScore for 10.1101/2021.01.28.21250669: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    The data analysis was performed with SAS Studio statistical software (ver. 5.2, SAS Institute Inc., Cary, NC).
    SAS Institute
    suggested: (Statistical Analysis System, RRID:SCR_008567)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Besides, patients with complex medical needs (such as multiple chronic conditions, functional limitations, and other health issues) may have been told only to seek care for urgent problems, but their delayed management may have worsened their condition. Several policies could help primary care to build capacity in the short term and mitigate the effects of future crises. For instance, policymakers can help primary care providers develop an adequate telehealth infrastructure and offer them fair reimbursement. A more robust and well-functioning primary care system is now needed more than ever to save lives in an increasingly daunting health crisis [20]. Our Model 2 considered all six province-related indicators as covariates, including the COVID-19 transmission factor (which considers the different rates of COVID-19 transmission across Italy’s provinces). Adding this transmission factor captures most of the variability in excess mortality at a province level. The model nonetheless confirms the significance of AIDS mortality and the density of GPs as explanatory variables. The long-term care hospitalization rate also becomes significantly and positively associated with excess mortality. This result may mean that, after controlling for the rate of COVID-19 transmission across provinces, excess mortality is strongly influenced by the incidence of individuals with a high health risk among the population infected. In other words, a large part of the excess deaths was attributable to...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • No funding statement was detected.
    • No protocol registration statement was detected.

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  3. Version published to 10.1101/2021.01.28.21250669 on medRxiv