以色列的 COVID 封锁措施轻微减少了整体预防性卫生服务的使用，但加剧了一些差异。
Israeli COVID lockdowns mildly reduced overall use of preventive health services, but exacerbated some disparities.
机构信息
Braun School of Public Health and Community Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Ein Kerem Campus, Jerusalem 9574425, Israel.
National Program for Quality Indicators in Community Healthcare in Israel, Ein Kerem Campus, Jerusalem 9574425, Israel.
出版信息
Int J Qual Health Care. 2022 Sep 16;34(3). doi: 10.1093/intqhc/mzac071.
BACKGROUND
During 2020, Israel experienced two COVID-19-related lockdowns that impacted the provision of primary and secondary preventive care.
METHODS
We examined the month-by-month performance of selected preventive care services using data from Israel's national Quality Indicators in Community Healthcare program. Process of care measures included hemoglobin A1c (HbA1c) testing, cholesterol testing, colon cancer screening and mammography. Intermediate outcome measures included low-density lipoprotein control and HbA1c control. Measures were stratified by sex and by area-level socioeconomic position (SEP). Diabetes and mammography are presented in this abstract due to space limitations.
RESULTS
Annual HbA1c testing among persons with diabetes decreased from 90.9% in 2019 to 88.0% in 2020. Performance of HbA1c tests during lockdown months was as low as half the usual amount. There were compensatory increases in testing during post-lockdown months that did not quite make up for the missed tests. In 2019, 9.0% of Israelis with diabetes had poor glycemic control (HbA1c ≥ 9.0); in 2020, it was 8.8%. In total, 4.5% fewer mammograms were performed in 2020 compared with 2019. Women in the lowest SEP level performed 10.4% fewer mammograms in 2020 than in 2019, while women in the highest SEP level performed 3.1% more mammograms.
CONCLUSIONS
Prolonged COVID lockdowns in 2020 were associated with marked decreases in the performance of preventive health services during those months. Compensatory spikes following the end of lockdowns partly, but did not completely, make up for the missed care. COVID lockdowns may have exacerbated socioeconomic disparities in some preventive health services.
背景
2020 年期间，以色列经历了两次与 COVID-19 相关的封锁，这影响了初级和二级预防保健的提供。
方法
我们使用以色列国家社区医疗保健质量指标计划的数据，逐月检查选定预防保健服务的表现。护理过程措施包括血红蛋白 A1c（HbA1c）检测、胆固醇检测、结肠癌筛查和乳房 X 光检查。中间结果措施包括低密度脂蛋白控制和 HbA1c 控制。这些措施按性别和地区社会经济地位（SEP）进行分层。由于篇幅限制，本文仅呈现糖尿病和乳房 X 光检查的结果。
结果
2019 年，糖尿病患者的年度 HbA1c 检测率为 90.9%，2020 年降至 88.0%。封锁期间的 HbA1c 检测量低至正常水平的一半。封锁后几个月的检测量有所增加，但仍未能弥补错过的检测。2019 年，有 9.0%的糖尿病患者血糖控制不佳（HbA1c≥9.0%），2020 年为 8.8%。与 2019 年相比，2020 年总共减少了 4.5%的乳房 X 光检查。2020 年，社会经济地位最低的女性进行的乳房 X 光检查比 2019 年减少了 10.4%，而社会经济地位最高的女性进行的乳房 X 光检查则增加了 3.1%。
结论
2020 年 COVID 封锁时间延长，导致这些月份预防保健服务的实施明显减少。封锁结束后的补偿性激增在一定程度上弥补了错过的护理，但并未完全弥补。COVID 封锁可能加剧了某些预防保健服务中社会经济差异。
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