Western Sydney Local Health District, Blacktown Hospital, 18 Blacktown Road, Blacktown, NSW, 2148, Australia.
Population Wellbeing and Environment Research Lab, School of Health and Society, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, Australia.
BMC Health Serv Res. 2023 Feb 16;23(1):167. doi: 10.1186/s12913-023-09168-2.
Avoidance of health services, in particular hospital and community services, is problematic for people with diabetes. Evidence has demonstrated that such missed attendances are associated with worse health, faster declines in functioning, and higher rates of mortality long-term. This paper investigated the impact of the pandemic on healthcare access across community and hospital care, including Virtual Care (VC) using several large datasets of General Practice (GP) and hospital services in western Sydney.
A retrospective cohort study using a time-series database of 173,805 HbA tests done at Blacktown and Mt Druitt hospitals and 1.8 million recorded consultations at GP clinics in the region was undertaken.
The average rate of diabetes in Emergency Department fell from 17.8% pre-pandemic to 11% after January 2020 (p < 0.001). This rate varied substantially over time, and correlated well with large outbreaks of COVID-19 in the state. Conversely, attendances of people with diabetes to GP clinics, especially using VC services, increased substantially over the pandemic period.
DISCUSSION/CONCLUSION: During the pandemic there was a substantial avoidance of hospital care by patients with diabetes. However, this may have been replaced by VC offered in the community for those with less severe diseases.
对于糖尿病患者来说，避免使用医疗服务，特别是医院和社区服务，是一个问题。有证据表明，这种错过就诊与更差的健康状况、功能更快下降以及长期更高的死亡率有关。本文通过使用西悉尼地区几个大型全科医疗（GP）和医院服务数据集，调查了大流行对社区和医院护理中医疗保健获取的影响，包括虚拟护理（VC）。
采用回顾性队列研究，使用黑镇和 Mt Druitt 医院的 173805 次 HbA 检测和该地区 180 万次记录就诊的时间序列数据库进行研究。
急诊部门的糖尿病平均发病率从大流行前的 17.8%降至 2020 年 1 月后的 11%（p<0.001）。这一比率随时间变化很大，与该州 COVID-19 的大规模爆发密切相关。相反，糖尿病患者到全科诊所就诊的人数，特别是使用 VC 服务的人数，在大流行期间大幅增加。
讨论/结论：在大流行期间，糖尿病患者大量避免了医院护理。然而，对于病情较轻的患者，社区提供的 VC 可能已经取代了医院护理。
