COVID-19 pandemic has disrupted the continuity of care for chronic patients: evidence from a cross-sectional retrospective study in a developing country

Abstract

Background Any disruption in continuity of care for patients with chronic conditions can lead to poor outcomes for the patients as well as great damage for the community and the health system. This study aims to determine the continuity of care for patients with chronic conditions such as hypertension and diabetes during COVID-19 pandemic. Methods Through a cross-sectional retrospective study, data registered in six health centers in Yazd, Iran were analyzed. Data included the number of patients with chronic conditions (hypertension and diabetes) and average daily admission during a year before COVID-19 pandemic and the similar period after COVID-19 outbreak. The experience of continuity of care was assessed applying a validated questionnaire from a sample of 198 patients. Data analysis was done using SPSS version 25. Descriptive statistics, independent T-Test and Multivariable regression were used for analysis. Findings Results indicate that both visit load of the patients with chronic conditions (hypertension and diabetes) and their average daily admission were decreased significantly during a year after COVID-19 pandemic compared to the similar period before COVID-19 outbreak. The moderate average score of the patients` experience towards continuity of care during the pandemic was also reported. Regression analysis showed that age for the diabetes patients and insurance status for the hypertension patients affect the COC mean scores. Conclusion COVID-19 pandemic causes serious decline in the continuity of care for patients with chronic conditions. Such a deterioration not only can lead to make these patients` condition worse in a long-term period but also it can make irreparable damages to the whole community and the health system. To make the health systems resilient particularly in disasters, serious attention should be taken into consideration among them, developing the tele-health technologies, improving the primary health care capacity, designing the applied responsive models of continuity of care, making multilateral participations and inter-sectoral collaborations, allocating sustainable resources, and enabling the patients with selfcare skills are more highlighted.

Impact effects of COVID‐19 pandemic on chronic disease patients: A longitudinal prospective study

“…This study showed a decline in the health condition in chronic patients due to the different measures implemented to avoid contagion by COVID-19, such as confinement and restrictions (Dehghani Tafti et al, 2023). In addition, there was saturation in access to medical care, delays in treatment, low patient compliance with medications, as well as reduced physical activity and unhealthy lifestyle habits (Karatas et al, 2021).…”

“…In Spain, some studies carried out only in diabetic patients found no significant changes during the lockdown and post-lockdown (Oliver et al, 2023;Palanca et al, 2022). However, to date, there are few studies that have evaluated the follow-up over time of clinical parameters in chronic patients (Dehghani Tafti et al, 2023;Fikree et al, 2023), and none have jointly analysed the most common chronic diseases as well as the short-and medium-term effects.…”

Healthcare Management in a Post-Pandemic World: Lessons Learned and Future Preparedness - A Review

“…Elective procedures and routine care were often postponed or cancelled, adversely affecting those with chronic conditions or in need of regular medical interventions. Moreover, it unveiled the vulnerabilities of specific demographic groups, such as the elderly and individuals with pre-existing conditions, thereby spotlighting the existing disparities in healthcare access and outcomes (Dehghani Tafti et al, 2023;Organization, 2020).…”

Impact of COVID-19 on mortality in the canton of Sarajevo in period 2020-2022

“…There was a lack of maintenance of chronic illnesses like diabetes and chronic heart diseases because primary healthcare facilities were overburdened with COVID-19 patients, while chronic patients were fearful to visit their primary physician or to call 911 during an emergency, such as a heart attack or stroke. 2 Of course, there is also reasonable possibility that some of the COVID-19 deaths could be due to other causes and not COVID-19. 3 There are reports of increase of death rates in many countries during the COVID-19 pandemic as well as shortening of life expectancy at birth.…”