Centre for Research in Health Economics, Universitat Pompeu Fabra, 08002 Barcelona, Spain.
Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, 08272 Barcelona, Spain.
Int J Environ Res Public Health. 2021 May 17;18(10):5335. doi: 10.3390/ijerph18105335.
The COVID-19 pandemic has had major impacts on population health not only through COVID-positive cases, but also via the disruption of healthcare services, which in turn has impacted the diagnosis and treatment of all other diseases during this time. We study changes in all new registered diagnoses in ICD-10 groups during 2020 with respect to a 2019 baseline. We compare new diagnoses in 2019 and 2020 based on administrative records of the public primary health system in Central Catalonia, Spain, which cover over 400,000 patients and 3 million patient visits. We study the ratio of new diagnoses between 2019 and 2020 and find an average decline of 31.1% in new diagnoses, with substantial drops in April (61.1%), May (55.6%), and November (52%). Neoplasms experience the largest decline (49.7%), with heterogeneity in the magnitudes of the declines across different types of cancer diagnoses. While we find evidence of temporal variation in new diagnoses, reductions in diagnoses early in the year are not recouped by the year end. The observed decline in new diagnoses across all diagnosis groups suggest a large number of untreated and undetected cases across conditions. Our findings provide a year-end summary of the impact of the pandemic on healthcare activities and can help guide health authorities to design evidence-based plans to target under-diagnosed conditions in 2021.
COVID-19 大流行不仅通过 COVID-19 阳性病例对人口健康产生了重大影响，还通过扰乱医疗保健服务产生了影响，这反过来又影响了在此期间所有其他疾病的诊断和治疗。我们研究了 2020 年所有新登记的 ICD-10 组诊断与 2019 年基线相比的变化。我们根据西班牙加泰罗尼亚中部公共初级卫生系统的行政记录比较了 2019 年和 2020 年的新诊断，该系统覆盖了超过 400,000 名患者和 300 万次患者就诊。我们研究了 2019 年和 2020 年之间新诊断的比例，发现新诊断的平均下降了 31.1%，4 月（61.1%）、5 月（55.6%）和 11 月（52%）的降幅较大。肿瘤的下降幅度最大（49.7%），不同类型癌症诊断的下降幅度存在异质性。虽然我们发现新诊断的时间变化存在证据，但年初诊断的减少在年底并未得到弥补。所有诊断组的新诊断数量下降表明，许多疾病的未治疗和未检出病例数量众多。我们的研究结果提供了年度末大流行对医疗保健活动影响的总结，并有助于指导卫生当局制定基于证据的计划，以在 2021 年针对诊断不足的情况。
