Cristóbal Cuadrado, Francisca Vidal, Jorge Pacheco, and Sandra Flores-Alvarado are with Escuela de Salud Pública, Universidad de Chile, Independencia, Región Metropolitana, Chile. Cristóbal Cuadrado is also with the Centre for Health Economics, University of York, York, UK. Jorge Pacheco is also with Facultad de Medicina, Universidad de Concepción, Concepción, Chile.
Am J Public Health. 2022 Aug;112(S6):S591-S601. doi: 10.2105/AJPH.2021.306587.
To examine the COVID-19 pandemic's impact on cancer care access in Chile, analyzing differential effects by insurance type, gender, and age. We conducted a quasi-experimental study using interrupted time series analysis. We used multiple data sources for a broad evaluation of cancer-related health care utilization from January 2017 to December 2020. We fit negative binomial models by population groups for a range of services and diagnoses. A sharp drop in oncology health care utilization in March was followed by a slow, incomplete recovery over 2020. Cumulative cancer-related services, diagnostic confirmations, and sick leaves were reduced by one third in 2020; the decrease was more pronounced among women and the publicly insured. Early diagnosis was missed in 5132 persons with 4 common cancers. The pandemic stressed the Chilean health system, decreasing access to essential services, with a profound impact on cancer care. Oncology service reductions preceded large-scale lockdowns and supply-side disruptions. Importantly, not all population groups were equally affected, with patterns suggesting that gender and socioeconomic inequalities were exacerbated. (. 2022;112(S6):S591-S601. https://doi.org/10.2105/AJPH.2021.306587).
为了研究 COVID-19 大流行对智利癌症护理可及性的影响，我们分析了不同保险类型、性别和年龄的差异影响。我们使用了准实验研究，采用中断时间序列分析。我们使用了多个数据源，从 2017 年 1 月到 2020 年 12 月，对癌症相关医疗保健的使用进行了广泛评估。我们针对不同的人群分组，采用负二项式模型，对一系列服务和诊断进行了分析。在 2020 年 3 月，肿瘤学医疗保健的使用急剧下降，随后在 2020 年期间缓慢而不完全地恢复。2020 年癌症相关服务、诊断确认和病假减少了三分之一；在女性和公共保险人群中，降幅更为显著。4 种常见癌症的 5132 名患者错过了早期诊断。大流行给智利的卫生系统带来了压力，减少了对基本服务的获取，对癌症护理产生了深远影响。肿瘤学服务的减少先于大规模封锁和供应端的中断。重要的是，并非所有人群都受到同等影响，各种模式表明，性别和社会经济不平等现象加剧了。（2022；112(S6):S591-S601. https://doi.org/10.2105/AJPH.2021.306587）。
