Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
BMJ Open. 2022 Aug 16;12(8):e063150. doi: 10.1136/bmjopen-2022-063150.
The COVID-19 pandemic has a significant spill-over effect on people with non-communicable diseases (NCDs) over the long term, beyond the direct effect of COVID-19 infection. Evaluating changes in health outcomes, health service use and costs can provide evidence to optimise care for people with NCDs during and after the pandemic, and to better prepare outbreak responses in the future.
This is a population-based cohort study using electronic health records of the Hong Kong Hospital Authority (HA) CMS, economic modelling and serial cross-sectional surveys on health service use. This study includes people aged ≥18 years who have a documented diagnosis of diabetes mellitus, hypertension, cardiovascular disease, cancer, chronic respiratory disease or chronic kidney disease with at least one attendance at the HA hospital or clinic between 1 January 2010 and 31 December 2019, and without COVID-19 infection. Changes in all-cause mortality, disease-specific outcomes, and health services use rates and costs will be assessed between pre-COVID-19 and-post-COVID-19 pandemic or during each wave using an interrupted time series analysis. The long-term health economic impact of healthcare disruptions during the COVID-19 pandemic will be studied using microsimulation modelling. Multivariable Cox proportional hazards regression and Poisson/negative binomial regression will be used to evaluate the effect of different modes of supplementary care on health outcomes.
The study was approved by the institutional review board of the University of Hong Kong, the HA Hong Kong West Cluster (reference number UW 21-297). The study findings will be disseminated through peer-reviewed publications and international conferences.
COVID-19 大流行对患有非传染性疾病（NCD）的人群产生了长期的重大溢出效应，超出了 COVID-19 感染的直接影响。评估健康结果、卫生服务利用和成本的变化，可以为大流行期间和之后优化 NCD 患者的护理提供证据，并为未来更好地应对疫情爆发做好准备。
这是一项基于人群的队列研究，使用香港医院管理局（HA）CMS 的电子健康记录、经济建模和卫生服务利用的系列横断面调查。本研究纳入了年龄≥18 岁、有糖尿病、高血压、心血管疾病、癌症、慢性呼吸道疾病或慢性肾脏病诊断记录且至少在 2010 年 1 月 1 日至 2019 年 12 月 31 日期间在 HA 医院或诊所就诊一次以上、且未感染 COVID-19 的患者。使用中断时间序列分析，在 COVID-19 大流行前和大流行后或每个疫情期间评估全因死亡率、疾病特异性结局以及卫生服务利用率和成本的变化。使用微观模拟模型研究 COVID-19 大流行期间医疗保健中断对卫生经济学的长期影响。多变量 Cox 比例风险回归和泊松/负二项回归将用于评估不同补充护理模式对健康结果的影响。
该研究得到了香港大学和 HA 香港西区（参考号 UW 21-297）机构审查委员会的批准。研究结果将通过同行评审的出版物和国际会议进行传播。
