Change in healthcare during Covid-19 pandemic was assessed through observational designs.
J Clin Epidemiol
; 142: 45-53, 2022 02.
Article
in English
| MEDLINE | ID: covidwho-1482687
ABSTRACT
OBJECTIVE:
Methodological challenges for investigating the changes in healthcare utilization during COVID-19 pandemic must be considered for obtaining unbiased estimates. STUDY DESIGN ANDSETTING:
A population-based study in the Lombardy region (Italy) measured the association between the level of epidemic restrictions (increasing exposure during pre-epidemic, post-lockdown, and lockdown periods) and the recommended healthcare (outcome) for patients with schizophrenia, heart failure, chronic obstructive pulmonary disease, breast cancer, and pregnancy women. Two designs are applied the self-controlled case series (SCCS) and the usual cohort design. Adjustments for between-patients unmeasured confounders and seasonality of medical services delivering were performed.RESULTS:
Compared with pre-epidemic, reductions in delivering recommended healthcare during lockdown up to 73% (95% confidence interval 63%-80%) for timeliness of breast cancer surgery, and up to 20% (16%-23%) for appropriated gynecologic visit during pregnancy were obtained from SCCS and cohort design, respectively. Healthcare provision came back to pre-epidemic levels during the post-lockdown, with the exception of schizophrenic patients for whom the SCCS showed a reduction in continuity of care of 11% (11%-12%).CONCLUSION:
Strategies for investigating the changes in healthcare utilization during pandemic must be implemented. Recommendations for taking into account sources of systematic uncertainty are discussed and illustrated by using motivating examples.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Chronic Disease
/
COVID-19
/
Health Services Accessibility
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Systematic review/Meta Analysis
Limits:
Humans
Country/Region as subject:
Europa
Language:
English
Journal:
J Clin Epidemiol
Journal subject:
Epidemiology
Year:
2022
Document Type:
Article
Affiliation country:
J.jclinepi.2021.10.015
Similar
MEDLINE
...
LILACS
LIS