De Sarro Caterina, Papadopoli Rosa, Morgante Maria Carmela, Pileggi Claudia
Department of Health Sciences, University of Catanzaro "Magna Græcia", Catanzaro, Italy.
FAS@UMG Research Center, Department of Health Science, School of Medicine, University of Catanzaro, Catanzaro, Italy.
Front Med (Lausanne). 2023 Oct 12;10:1261063. doi: 10.3389/fmed.2023.1261063. eCollection 2023.
The aim of our study was to investigate the impact of the COVID-19 pandemic on the healthcare and the disease management of patients affected by non-communicable diseases (NCDs), by exploring, specifically, the obstacles encountered in the access to healthcare services during the latest phase of the pandemic.
This cross-sectional study was carried out among subjects attending the anti-SARS-CoV2 vaccination clinic in a Teaching Hospital of Southern Italy. To be included in the study, subjects had to be affected by at least one NCD, such as diabetes, hypertension, respiratory and heart diseases, renal and liver chronic conditions, immunodeficiency disorders due to cancer, or being kidney or liver transplant recipients.
Among the 553 subjects who completed the questionnaire, the 39.4% (95% IC = 35.3-43.6) experienced obstacles in the access to healthcare services in the six months prior to the enrollment. The most frequent canceled/postponed healthcare services were the visits for routine checks for NCDs (60.6, 95% IC = 53.9-67), control visits of more complex diseases as cancer or transplantation (17.3, 95% IC = 12.6-22.8), and scheduled surgery (11.5, 95% IC = 7.7-16.4). The patients who experienced canceled/postponed healthcare services were significantly more likely to suffer from 3 or more NCDs ( = 0.042), to be diabetics ( = 0.038), to have immunodeficiency disorders ( = 0.028) and to have consulted GP at least once ( = 0.004).
Our results appear to be fundamental for guiding the choices of providers in order to concentrate organizational efforts to recover and reschedule missed appointments, where applicable, of the most fragile patients by virtue of age and chronic conditions.
我们研究的目的是通过具体探讨在新冠疫情最后阶段获得医疗服务过程中遇到的障碍，来调查新冠疫情对非传染性疾病（NCD）患者的医疗保健和疾病管理的影响。
这项横断面研究是在意大利南部一家教学医院的抗SARS-CoV2疫苗接种诊所的受试者中进行的。要纳入该研究，受试者必须患有至少一种非传染性疾病，如糖尿病、高血压、呼吸道和心脏疾病、肾脏和肝脏慢性病、因癌症导致的免疫缺陷疾病，或者是肾脏或肝脏移植受者。
在完成问卷的553名受试者中，39.4%（95%置信区间=35.3-43.6）在入组前六个月获得医疗服务时遇到障碍。最常取消/推迟的医疗服务是针对非传染性疾病的常规检查（60.6，95%置信区间=53.9-67）、对癌症或移植等更复杂疾病的复诊（17.3，95%置信区间=12.6-22.8）以及预定的手术（11.5，95%置信区间=7.7-16.4）。经历过取消/推迟医疗服务的患者患3种或更多非传染性疾病（P=0.042）、患糖尿病（P=0.038）、有免疫缺陷疾病（P=0.028）以及至少咨询过一次全科医生（P=0.004）的可能性显著更高。
我们的结果对于指导医疗服务提供者的选择似乎至关重要，以便在适用的情况下集中组织力量，为因年龄和慢性病而最脆弱的患者恢复和重新安排错过的预约。
