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The effect of COVID-19 on utilization of chronic diseases services
Ghobad Moradi1, Bakhtiar Piroozi1, Fariba Khayyati1
1Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
Insights
The COVID-19 pandemic significantly decreased utilization of chronic disease services in Iran, with notable drops in heart failure and chemotherapy. However, asthma, type 2 diabetes, and chemotherapy services later saw significant increases.
Area of Science:
- Health Services Research
- Epidemiology
- Public Health
Background:
- Chronic diseases pose a significant risk for severe COVID-19 outcomes.
- Understanding the impact of the pandemic on healthcare service utilization is crucial for managing chronic conditions.
Purpose of the Study:
- To evaluate the impact of the COVID-19 pandemic on the utilization of chronic disease services in Iran.
- To analyze changes in service utilization for conditions including COPD, asthma, type 2 diabetes, heart failure, and chemotherapy.
Main Methods:
- An interrupted time-series design was employed to compare service utilization before and during the COVID-19 pandemic.
- Data from 24 hospital sites in Iran were collected for 12 months pre-pandemic (March 2019-February 2020) and 12 months during the pandemic (February 2020-March 2021).
- Services for chronic obstructive pulmonary disease (COPD), asthma, type 2 diabetes, heart failure, and chemotherapy were analyzed.
Main Results:
- A total of 7,039,378 services were provided, with 51.92% for women and 62.73% for individuals over 65.
- A significant decrease in monthly service utilization was observed during the pandemic, particularly for heart failure and chemotherapy.
- While COPD service utilization decreased, trends for asthma, type 2 diabetes, and chemotherapy services showed significant increases post-initial decline.
Conclusions:
- The COVID-19 pandemic initially led to a substantial reduction in the utilization of essential chronic disease services in Iran.
- Despite initial declines, some services like asthma and type 2 diabetes management eventually rebounded.
- The disruption in accessing care for chronic conditions during the pandemic highlights challenges in healthcare delivery and patient engagement.
Objectives:
The aim of the present study is to evaluate the impact of Covid-19 on utilization of chronic diseases services.
Methods:
Interrupted time-series design was used to examine the utilization of chronic diseases services before and during the Covid-19 pandemic among hospitals in Iran. Chronic obstructive pulmonary disease (COPD), asthma, type 2 diabetes, heart failure, and chemotherapy were selected as a proxy to indicate the impact of Covid-19 on utilization of chronic diseases services. Data were collected in 24 sites from 12 months before the onset of Covid-19 (from March 2019 to February 2020) to 12 months during the Covid-19 pandemic (February 2020 to March 2021).
Results:
A total of 7,039,378 services were provided, of which 51.92% were provided for women and 62.73% for >65 age group. A sudden decrease was observed in monthly utilization of services during the Covid-19 pandemic; ranging from 13.91 (95% CI = -21.73, 6.10, P = 0.001) for chemotherapy to 606.39 (95% CI = -1040.72, 172.06, P = 0.009) for heart failure services per 100 thousand population. A decrease was observed in COPD services; 15.28 services compared with the period before Covid-19. Subsequently, the monthly utilization trends of asthma, type 2 diabetes, and chemotherapy services increased significantly (P < 0.05).
Discussion:
Although chronic diseases are a factor in more severe form of Covid-19, their failure to seek diagnostic, prevention and treatment services has somewhat complicated the issue.
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