Schäfer Ines, Haack Alena, Neumann Marie, Koch-Gromus Uwe, Scherer Martin, Petersen Elina
Epidemiologisches Studienzentrum, Universitätsklinikum Hamburg-Eppendorf, 2. OG, Christoph-Probst-Weg 3, 20251, Hamburg, Deutschland.
Universitäres Herz- und Gefäßzentrum, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2023 Mar;66(3):275-282. doi: 10.1007/s00103-023-03665-9. Epub 2023 Feb 1.
The COVID-19 pandemic is also impacting the medical care for other diseases. The extent to which people with chronic diseases are affected by the suspension of medical services is investigated-differentiating between patient and provider perspectives.
A cross-sectional study was conducted based on data from the longitudinal Hamburg City Health Study (HCHS). The study population was all HCHS participants (a sample of the population of Hamburg, 45-74 years) between April 2020 and November 2021. Utilisation of medical services was collected via the "COVID-19-module" of the HCHS. The chronic conditions included cardiovascular disease, kidney and lung disease, cancer and diabetes mellitus; analyses were descriptive and multivariate.
Of the 2047 participants, 47.9% had at least one previous illness. Of those with pre-existing conditions, 21.4% had at least one healthcare service suspended or an appointment cancelled. In addition, 15.4% stated that they decided by themselves not to attend a doctor's appointment. Specialist care services (43.8% of all cancellations) were cancelled more frequently than general practitioner care (16.6%). After adjustment for age, gender and education, lung disease (OR 1.80; p < 0.008) and cancer (OR 2.33; p < 0.001) were found to be independent risk factors for appointment cancellations by healthcare providers. Of cancellations by patients, 42.2% were due to their fear of an infection with the coronavirus SARS-CoV‑2.
Health policy and the media are faced with the challenge of dealing with fears of infection in the population in such a way that they do not lead to an avoidance of necessary care services.
新冠疫情也在影响其他疾病的医疗护理。本研究调查了慢性病患者受医疗服务暂停影响的程度,并区分了患者和提供者的观点。
基于汉堡城市纵向健康研究(HCHS)的数据进行了一项横断面研究。研究人群为2020年4月至2021年11月期间所有HCHS参与者(汉堡市45 - 74岁人群的样本)。通过HCHS的“新冠模块”收集医疗服务利用情况。慢性病包括心血管疾病、肾脏和肺部疾病、癌症以及糖尿病;分析采用描述性和多变量分析。
在2047名参与者中,47.9%曾患至少一种疾病。在患有既往疾病的人群中,21.4%至少有一项医疗服务暂停或预约取消。此外,15.4%的人表示他们自行决定不赴医生预约。专科护理服务(占所有取消预约的43.8%)比全科医生护理(16.6%)更频繁地被取消。在对年龄、性别和教育程度进行调整后,发现肺部疾病(OR 1.80;p < 0.008)和癌症(OR 2.33;p < 0.001)是医疗服务提供者取消预约的独立危险因素。在患者取消预约中,42.2%是由于他们担心感染冠状病毒SARS-CoV-2。
卫生政策和媒体面临着应对民众感染恐惧的挑战,要确保这种恐惧不会导致人们回避必要的医疗服务。