Hernández-Vásquez Akram, Barrenechea-Pulache Antonio, Portocarrero-Bonifaz Andres, Rojas-Roque Carlos, Gamboa-Unsihuay Jesús Eduardo
Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru.
Universidad Científica del Sur, Lima, Peru.
Prev Med Rep. 2022 Aug;28:101884. doi: 10.1016/j.pmedr.2022.101884. Epub 2022 Jul 4.
COVID-19 has disrupted the treatment of non-communicable diseases (NCDs). This study conducted a multimorbidity analysis and evaluated hospital admissions and death rates among diabetic patients before and after the implementation of lockdown due to the COVID-19 pandemic in Peru. Data from the Ministry of Health (MINSA) of Peru from January 2017 to December 2020 was used. Hospital death, discharge and the percentage of death/hospital admissions were defined as outcomes of interest. We performed an interrupted time series analysis to assess the aggregate change in the outcomes of interest before and after mandatory lockdown in response to the COVID-19 pandemic in Peru (n = 65,935). Additionally, a network analysis was performed to evaluate the frequency of occurrence of hospital admissions before and after the mandatory lockdown according to demographic characteristics. The average monthly hospital admissions among diabetic patients in Peru decreased by 29% after the implementation of the lockdown. The largest reduction was observed in women (-41%) and for patients 60 years or older (-35%). Furthermore, there was a 92% increase in the average number of monthly deaths. The largest percentage change occurred in men (+113%) and in the group of 40-59 years (+144%). After the implementation of lockdown in Peru, hospital admissions among diabetic patients significantly decreased while in-hospital mortality slightly increased. Our findings shed light on the limitations of the Peruvian health system and the importance of ensuring continued care of NCDs as part of the response strategy during times of crisis.
新冠疫情扰乱了非传染性疾病（NCDs）的治疗。本研究进行了多重疾病分析，并评估了秘鲁因新冠疫情实施封锁前后糖尿病患者的住院率和死亡率。使用了秘鲁卫生部（MINSA）2017年1月至2020年12月的数据。将医院死亡、出院以及死亡/住院率定义为感兴趣的结果。我们进行了中断时间序列分析，以评估秘鲁因应对新冠疫情而实施强制封锁前后感兴趣结果的总体变化（n = 65,935）。此外，还进行了网络分析，以根据人口统计学特征评估强制封锁前后住院的发生频率。秘鲁实施封锁后，糖尿病患者的月平均住院率下降了29%。降幅最大的是女性（-41%）和60岁及以上患者（-35%）。此外，月平均死亡人数增加了92%。变化百分比最大的是男性（+113%）和40 - 59岁年龄组（+144%）。秘鲁实施封锁后，糖尿病患者的住院率显著下降，而住院死亡率略有上升。我们的研究结果揭示了秘鲁卫生系统的局限性，以及在危机期间确保将非传染性疾病的持续护理作为应对策略一部分的重要性。
