The COVID-19 Pandemic and Access to Selected Ambulatory Care Services Among Populations With Severely Uncontrolled Diabetes and Hypertension in Massachusetts.
The COVID-19 Pandemic and Access to Selected Ambulatory Care Services Among Populations With Severely Uncontrolled Diabetes and Hypertension in Massachusetts.
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DOI：
10.1177/00333549211065515
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发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Pennock JN
中科院分区：
文献类型：
--
作者：
Nielsen VM;Song G;Ojamaa LS;Blodgett RP;Rocchio CM;Pennock JN
马萨诸塞州爆发的 COVID-19 可能减少了门诊护理的获取。我们的研究旨在量化这种对糖尿病和高血压严重不受控制的人群的影响；这些人群因护理中断而遭受不良后果的风险最大。我们分析了来自 MDPHnet 的多学科动态电子健康记录数据。我们使用 2017 年、2018 年和 2019 年的数据建立了 3 个严重未控制的糖尿病患者队列和 3 个严重未控制的高血压患者队列，然后对每个队列进行了接下来的 15 个月的随访。对于糖尿病队列，我们每季度生成一次糖化血红蛋白 A1c (HbA1c) 测试计数。对于高血压人群，我们每月生成血压测量值计数。最后，我们评估了 2019 年糖尿病和高血压人群从 2020 年 1 月到 2021 年 3 月的远程医疗使用情况。与前几年相比，大流行期间 HbA1c 测试和血压监测大幅下降。在 2019 年糖尿病队列中，HbA1c 测量值从 2020 年 1 月至 3 月（基线）的 44.0% 下降至 2020 年 4 月至 6 月的 15.9%，比 2021 年 1 月至 3 月基线低 11.8 个百分点。在 2019 年高血压队列中，血压测量值从 2020 年 1 月的 40.0% 下降至 4 月的 4.5% 2020 年，远程医疗的使用率比 2021 年 3 月的基线低 23.5 个百分点。在大流行期间，远程医疗的使用急剧增加，但不同亚人群的情况并不一致。在疫情期间，疾病严重不受控制的人群获得特定糖尿病和高血压服务的机会急剧下降。尽管远程医疗是一项重要战略，但确保获得公平性也至关重要。远程医疗混合模式还可以最大限度地减少护理中断。
The outbreak of COVID-19 in Massachusetts may have reduced ambulatory care access. Our study aimed to quantify this impact among populations with severely uncontrolled diabetes and hypertension; these populations are at greatest risk for adverse outcomes caused by disruptions in care. We analyzed multidisciplinary ambulatory electronic health record data from MDPHnet. We established 3 cohorts of patients with severely uncontrolled diabetes and 3 cohorts of patients with severely uncontrolled hypertension using 2017, 2018, and 2019 data, then followed each cohort through the subsequent 15 months. For the diabetes cohorts, we generated quarterly counts of glycated hemoglobin A1c (HbA1c) tests. For the hypertension cohorts, we generated monthly counts of blood pressure measurements. Finally, we assessed telehealth use among the 2019 diabetes and hypertension cohorts from January 2020 through March 2021. HbA1c testing and blood pressure monitoring dropped considerably during the pandemic compared with previous years. In the 2019 diabetes cohort, HbA1c measurements declined from 44.0% in January–March 2020 (baseline) to 15.9% in April–June 2020 and was 11.8 percentage points below baseline in January–March 2021. In the 2019 hypertension cohort, blood pressure measurements declined from 40.0% in January 2020 to 4.5% in April 2020 and was 23.5 percentage points below baseline in March 2021. Telehealth use increased precipitously during the pandemic but was not uniform across subpopulations. Access to selected diabetes and hypertension services declined sharply during the pandemic among populations with severely uncontrolled disease. Although telehealth is an important strategy, ensuring equity in access is essential. Telehealth hybrid models can also minimize disruptions in care.
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影响因子：
4.1
作者：
Lee DC;Gupta VK;Carr BG;Malik S;Ferguson B;Wall SP;Smith SW;Goldfrank LR
通讯作者：
Goldfrank LR
影响因子：
9.7
作者：
Kane, Carol K.;Gillis, Kurt
通讯作者：
Gillis, Kurt
DOI：
10.15585/mmwr.mm6918e2
发表时间：
2020-05-08
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
Schuchat A;CDC COVID-19 Response Team
通讯作者：
CDC COVID-19 Response Team
影响因子：
4.7
作者：
Compton, Martina;Soper, Morgan;Albon, Dana
通讯作者：
Albon, Dana
影响因子：
4.7
作者：
List, Rhonda;Compton, Martina;Albon, Dana
通讯作者：
Albon, Dana