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COVID-19 大流行对日本 1 型或 2 型糖尿病患者总体就诊情况和使用远程医疗的影响。

Influence of the COVID-19 Pandemic on Overall Physician Visits and Telemedicine Use Among Patients With Type 1 or Type 2 Diabetes in Japan.

机构信息

Department of Health Data Science, Yokohama City University Graduate School of Data Science.

Integrity Healthcare Co., Ltd.

出版信息

J Epidemiol. 2022 Oct 5;32(10):476-482. doi: 10.2188/jea.JE20220032. Epub 2022 Jul 13.

Abstract

BACKGROUND

Regular visits with healthcare professionals are important for preventing serious complications in patients with diabetes. The purpose of this retrospective cohort study was to clarify whether there was any suppression of physician visits among patients with diabetes during the spread of the novel coronavirus 2019 (COVID-19) in Japan and to assess whether telemedicine contributed to continued visits.

METHODS

We used the JMDC Claims database, which contains the monthly claims reported from July 2018 to May 2020 and included 4,595 (type 1) and 123,686 (type 2) patients with diabetes. Using a difference-in-differences analysis, we estimated the changes in the monthly numbers of physician visits or telemedicine per 100 patients in April and May 2020 compared with the same months in 2019.

RESULTS

For patients with type 1 diabetes, the estimates for total overall physician visits were -2.53 (95% confidence interval [CI], -4.63 to 0.44) in April and -8.80 (95% CI, -10.85 to -6.74) in May; those for telemedicine visits were 0.71 (95% CI, 0.47-0.96) in April and 0.54 (95% CI, 0.32-0.76) in May. For patients with type 2 diabetes, the estimates for overall physician visits were -2.50 (95% CI, -2.95 to -2.04) in April and -3.74 (95% CI, -4.16 to -3.32) in May; those for telemedicine visits were 1.13 (95% CI, 1.07-1.20) in April and 0.73 (95% CI, 0.68-0.78) in May.

CONCLUSION

The COVID-19 pandemic was associated with suppression of physician visits and a slight increase in the utilization of telemedicine among patients with diabetes during April and May 2020.

摘要

背景

定期与医疗保健专业人员进行就诊对于预防糖尿病患者出现严重并发症至关重要。本回顾性队列研究的目的是阐明在日本新型冠状病毒 2019(COVID-19)传播期间,糖尿病患者的就诊是否受到抑制,并评估远程医疗是否有助于持续就诊。

方法

我们使用了 JMDC 理赔数据库,该数据库包含 2018 年 7 月至 2020 年 5 月期间每月的理赔报告,其中包括 4595 名(1 型)和 123686 名(2 型)糖尿病患者。通过差异分析,我们估计了 2020 年 4 月和 5 月与 2019 年同期相比,每 100 名患者的每月就诊次数或远程医疗就诊次数的变化。

结果

对于 1 型糖尿病患者,总整体就诊次数的估计值在 4 月为-2.53(95%置信区间[CI],-4.63 至 0.44),在 5 月为-8.80(95%CI,-10.85 至 -6.74);远程医疗就诊次数的估计值在 4 月为 0.71(95%CI,0.47-0.96),在 5 月为 0.54(95%CI,0.32-0.76)。对于 2 型糖尿病患者,总整体就诊次数的估计值在 4 月为-2.50(95%CI,-2.95 至 -2.04),在 5 月为-3.74(95%CI,-4.16 至 -3.32);远程医疗就诊次数的估计值在 4 月为 1.13(95%CI,1.07-1.20),在 5 月为 0.73(95%CI,0.68-0.78)。

结论

COVID-19 大流行与 2020 年 4 月和 5 月期间糖尿病患者就诊次数减少和远程医疗利用率略有增加有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9830/9424188/5f5b2dcd5ace/je-32-476-g001.jpg

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