IMPACT OF THE COVID-19 PANDEMIC ON HEALTHCARE ACCESS, DELIVERY AND VACCINATION IN PATIENTS WITH DIGESTIVE DISORDERS

ABSTRACT

Aims: COVID-19 has exacted a worldwide devastating toll, not only through its direct effects, but also through wide-ranging indirect effects on access to and delivery of healthcare. We conducted a survey to better understand the pandemic's impact in patients with digestive disorders. We also sought to understand the rate of COVID-19 vaccination and barriers to vaccination amongst persons with digestive disorders. Methods: A web-based survey was conducted through the International Foundation for Gastrointestinal Disorders (IFFGD) website. The survey was open, internationally accessible from 8/11/21-11/17/21 and completed via the Alchemer survey tool. There were 57 questions related to demographic variables, classification of GI symptoms/disorders, care delivery and illness experience during the pandemic. Patients were also asked about their vaccination status and opinions toward receiving the vaccine. No compensation was provided. Results: Of the 322 survey responders, 210 reported chronic GI illness and were included in the analysis. Demographics are provided in table 1. Most survey respondents (68%) had disorders of gut-brain interaction (DGBI). Overall, 70% of respondents stated the pandemic impacted their gastroenterological health. Most notably, 40% of respondents reported accessing their provider during the pandemic was somewhat difficult, while 14% found it very difficult. More than half (58%) received less frequent care or access to their provider, and almost 3 in 4 visits (71%) were completed virtually. Virtual care was perceived to be of lesser quality by 38% of respondents. Procedures and/or tests were delayed > 3 months in more than half (54%). Strikingly, nearly a third (30%) reported a decrease in income that made it more difficult to see their provider, purchase a prescription or afford healthy food. In a univariable analysis, non-white participants were more likely to have a loss of income and negative impact on their access to care (p <0.04). While >80% of respondents were vaccinated for COVID-19, one in seven (16%) were unvaccinated. Demographic and disease characteristics of unvaccinated respondents can be found in table 2. Over 80% of the unvaccinated felt well informed about the risks of contracting COVID. Sixty-three percent chose not to be vaccinated because of anxiety about side effects. For unvaccinated respondents, 19% (6/32) were advised by a healthcare professional to not be vaccinated because of their GI illness. Conclusions: This survey shows that the pandemic negatively affected patients with digestive disorder's access to healthcare, disproportionately affecting those who are non-white. Additionally, we identified an important, potentially correctible gap in education surrounding COVID-19 vaccination in those with digestive disorders. (Table Presented) Table 1. Demographic characteristics of survey respondents (n 210) (Table Presented) Table 2. Demographic characteristics and primary GI conditions of unvaccinated survey respondents (n32)