The effect of COVID-19 on utilization of chronic diseases services

• Published in: Chronic illness Vol. 20; no. 2; pp. 309 - 319
• Main Authors: Moradi, Ghobad, Piroozi, Bakhtiar, Khayyati, Fariba, Moradpour, Farhad, Safari, Hossein, Mohamadi Bolbanabad, Amjad, Fattahi, Hamed, Younesi, Fatemeh, Ebrazeh, Ali, Shokri, Azad
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-06-2024; SAGE PUBLICATIONS, INC
• Subjects: Adult; Aged; Asthma; Asthma - epidemiology; Asthma - therapy; Chemotherapy; Chronic asthma; Chronic Disease - therapy; Chronic illnesses; Chronic obstructive pulmonary disease; COVID-19; COVID-19 - epidemiology; COVID-19 - therapy; Diabetes; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - therapy; Female; Heart failure; Heart Failure - epidemiology; Heart Failure - therapy; Hospitals; Humans; Interrupted Time Series Analysis; Iran - epidemiology; Male; Middle Aged; Original; Pandemics; Patient Acceptance of Health Care - statistics & numerical data; Prevention programs; Pulmonary Disease, Chronic Obstructive - epidemiology; Pulmonary Disease, Chronic Obstructive - therapy; SARS-CoV-2; Type 2 diabetes mellitus; Women; Iran; Covid-19; Iran; chronic diseases; services utilization
• ISSN: 1742-3953; 1745-9206
• DOI: 10.1177/17423953231178168

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.