The impact of COVID-19 and healthcare system changes on the well-being of rheumatic patients

Abstract

Objectives The COVID-19 pandemic has significantly impacted the healthcare systems. Many Polish outpatient clinics have been implementing telemedical consultations as a tool to ensure the continuity of care for patients with chronic diseases. The aim of the study was to evaluate patients’ satisfaction with telemedical appointments, as well as availability of the various medical services and patients’ well-being during the pandemic. Material and methods An online-based questionnaire on the experience with telemedical consultations, availability of medical services and current state of health was conducted among Polish rheumatology patients approximately 6 months after the outbreak of the COVID-19 pandemic. Results The survey was completed by 107 respondents with a mean age of 41.52 ±14.33 years. The overall level of satisfaction from telemedical consultations, evaluated with a VAS 1–10 scale, was assessed as 6.23 ±3.04 for teleconsultations in primary healthcare units and 6.00 ±2.80 for rheumatology outpatient units. 42.99% of the respondents were in favour of maintaining telemedical appointments even after the pandemic. Incidences of reduced access to medical services during the COVID-19 pandemic were reported by 77.57% of the patients. Almost half of the respondents reported reduced accessibility to rheumatological care. An alarming decline in health self-esteem, evaluated with a VAS 1–10 scale, was noted from the average 6.37 ±1.92 before COVID-19 to the current rating of 5.78 ±1.91 ( p = 0.0087). Conclusions Polish rheumatology patients are moderately satisfied with the medical teleconsultations in primary health care units and rheumatology outpatient clinics. A substantial number of patients experienced deterioration of well-being as well as limited access to traditional healthcare services, including rheumatology care.

Accessibility to Non-COVID Health Services in the World During the COVID-19 Pandemic: Review

“…The rate of telemedicine visits increased significantly from before to during the COVID-19 pandemic among patients with various chronic disease conditions, with the highest rates observed among patients in the mental illness subgroup, congestive heart failure, asthma, hypertension, diabetes, angina, and chronic obstructive pulmonary disease ( 51 ). An increase in access to telemedicine services was also observed in patients with rheumatic disease in Poland ( 35 ). Authors of a retrospective study from Kenya found an increase in health facility baby deliveries and measles vaccination ( 37 ).…”

“…Moreover, in Germany, during lockdowns, neurological emergency admissions of adults have declined, and out of all conditions, a decrease in admissions due to brain tumors was the highest ( 34 ). For oncology patients in the questionnaire-based study, the majority of the respondents experienced incidents of reduced access to medical services during the COVID-19 pandemic ( 35 ), and for patients with orthopedic injuries in Hong Kong, a decrease in the number of emergency visits was observed ( 36 ). Due to the transition of some facilities that were used to provide essential services to COVID-19 isolation units caused that patients with chronic illness in Kenya had difficulty getting the help they needed ( 37 ).…”

“…Hospitalizations due to COPD and asthma same as the primary diagnosis of pneumonia and influenza with pre-existing COPD or asthma decreased substantially in South Korea for patients with pulmonary disease ( 38 ). A questionnaire-based study among patients with rheumatic disease in Poland showed that the majority of the respondents experienced limitations in inpatient care, planned diagnostic hospitalization, and operating procedures ( 35 ). For patients with orthopedic injuries in Hong Kong, a decrease in the number of planned or urgent surgeries and hospitalizations was observed ( 36 ).…”

“…On the other hand in some developing countries, for example, Poland, studies showed an increase in telemedical consultations. Moreover, the overall level of satisfaction from telemedicine was evaluated as more than good ( 35 ). The effort of the Indian government for expanding the use of telemedicine in the face of the COVID-19 pandemic along with private sector initiatives offers promise for mitigating the dire limitations of healthcare.…”

How the COVID-19 Pandemic Affected the Accessibility and Quality of Health Services in Poland

“…As a result, the mortality rate also increased (D'Ascenzo et al, 2021). Based on the results of an online survey of rheumatic patients in Poland, it was found that 77.57% of respondents experienced a restriction to health services during the COVID-19 pandemic; 56.06% of respondents had a specialist clinic appointment cancelled; 31.77% stated that they did not receive medical care when needed, while 16.04% noted an improvement in the quality of telemedicine services (Opinc et al, 2021).…”