HIRA Research Institute, Health Insurance Review and Assessment Service (HIRA), Wonju, Korea.
Korea Pharmaceutical Information Service, Health Insurance Review and Assessment Service (HIRA), Wonju, Korea.
BMC Public Health. 2023 Aug 12;23(1):1538. doi: 10.1186/s12889-023-16430-z.
Access to healthcare services is important, especially for patients with chronic diseases. We evaluated the effect of the COVID-19 pandemic on outpatient visits and medication for patients with hypertension and diabetes in South Korea.
Nationwide claims data were extracted for patients with hypertension and diabetes from January 2019 to July 2020. We used an interrupted time series (ITS) analysis to evaluate the pandemic's impact on outpatient care using the number of outpatient visits and days of medication supplied per visit. We identified the change in the continuity of care in medication, a consequence of the change in outpatient care, using the Medication Possession Ratio (MPR).
The number of outpatient visits for diabetes significantly declined in February 2020, when community transmission began. However, when high-intensity social distancing was relaxed in April 2020, outpatient visits for hypertension and diabetes rebounded significantly. Moreover, when the outpatient visits declined, the number of days of medication supplied per visit increased. Consequently, the average MPRs significantly increased compared to 2019, increasing the ratio of patients with appropriate medication supply (MPR ≥ 0.8).
Outpatient visits decreased immediately when COVID-19 spread to local communities. However, the number of days of medication supplied per visit increased to compensate for the longer intervals between visits. Rather, the change in the continuity of care in medication improved; thus, the temporary decrease in outpatient visits might have had a limited negative impact on health outcomes.
获得医疗服务很重要,尤其是对于慢性病患者。我们评估了 COVID-19 大流行对韩国高血压和糖尿病患者的门诊就诊和药物治疗的影响。
从 2019 年 1 月至 2020 年 7 月,我们从全国范围内提取了高血压和糖尿病患者的索赔数据。我们使用中断时间序列(ITS)分析来评估大流行对门诊护理的影响,使用门诊就诊次数和每次就诊提供的药物天数来评估。我们使用药物使用比例(MPR)来确定药物治疗连续性的变化,这是门诊护理变化的结果。
当社区传播开始时,2020 年 2 月糖尿病的门诊就诊次数显著下降。然而,当 2020 年 4 月高强度社会隔离措施放松时,高血压和糖尿病的门诊就诊次数显著反弹。此外,当门诊就诊次数下降时,每次就诊提供的药物天数增加。因此,与 2019 年相比,平均 MPR 显著增加,适当药物供应的患者比例(MPR≥0.8)增加。
当 COVID-19 传播到当地社区时,门诊就诊立即减少。然而,每次就诊提供的药物天数增加以弥补就诊间隔时间的延长。相反,药物治疗连续性的变化得到改善;因此,门诊就诊次数的暂时减少可能对健康结果的负面影响有限。