Changes in Outpatient Health Care Use After COVID-19 Infection Among Veterans

JAMA Network Open, Год журнала: 2024, Номер 7(2), С. e2355387 - e2355387

Опубликована: Фев. 9, 2024

Importance The association of COVID-19 infection with outpatient care utilization is unclear. Many studies reported population surveillance rather than comparing health use between COVID-19–infected and uninfected cohorts. Objective To compare across 6 categories (primary care, specialty surgery mental health, emergency diagnostic and/or other care) veterans or without infection. Design, Setting, Participants In a retrospective cohort study Veterans Affairs primary patients, were matched to veterans. Data obtained from the Corporate Warehouse Centers for Medicare & Medicaid Services Fee-for-Service Carrier/Physician Supplier file January 2019 through December 2022. analysis was performed September 2022 April 2023. Exposure Main Outcomes Measures outcome count visits after Negative binomial regression models compared over 1-year preinfection period, peri-infection (0-30 days), intermediate (31-183 long-term (184-365 days) postinfection periods. Results infected (202 803 veterans; mean [SD] age, 60.5 [16.2] years; 178 624 men [88.1%]) 60.4 [16.5] cohorts well all covariates. Outpatient in (except surgical significantly elevated during period cohort, an increase 5.12 per 30 days (95% CI, 5.09-5.16 predominantly owing (increase 1.86 days; 95% 1.85-1.87 days). Differences attenuated time but remained statistically higher at 184 365 0.25 visit 0.23-0.27 One-half increased delivered via telehealth. greatest aged 85 years older (6.1 visits, 5.9-6.3 visits) vs those 20 44 (4.8 4.7-4.8 unvaccinated (4.5 4.3-4.6 vaccinated (3.2 visits; 3.4-4.8 visits). Conclusions Relevance This found that month infection, then greater cohorts’ 12 months, which suggests there are sustained impacts

Язык: Английский

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The effect of Covid-19 pandemic on healthcare utilization in public vs private centers in Iran: a multiple group interrupted time-series analysis

BMC Health Services Research, Год журнала: 2023, Номер 23(1)

Опубликована: Авг. 1, 2023

Abstract Background The outbreak of Coronavirus in late 2019 and its continuation the following years has affected all human societies, government organizations, health systems. Access to services is an important issue during crises. present study aimed investigate effect Covid-19 pandemic on consumption public sector compared private Iran. Methods research population consisted insured individuals covered by Iran Health Insurance Organization Fars province, which amounts approximately 2,700,000 people. required information including utilization laboratory, radiology, medicine, hospitalization was extracted a monthly basis from February 2021. Multiple Group Interrupted Time Series Analysis (MGITSA) used for data analysis along with STATA.15 software. Results According findings MGITSA, short-term, medication, hospital admissions had decreased 18,066, 8210, 135,445, 1086 times, respectively ( P < 0.05). In long-run, use laboratory radiology increased about 2312 514 times 0.05), respectively. comparison between sectors showed that 12,525, while medication 91,471 1514 = 0.076) no change observed other (in relative centers). Conclusions Utilization versus centers, except hospitalization, significantly short-term. However most returned usual trend long-term. reduction access could impose significant burden various diseases, at least increase costs coming years.

Язык: Английский

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Exploring the impact of the COVID-19 pandemic on patients with type 2 diabetes and primary care utilisation: a scoping review

Research Square (Research Square), Год журнала: 2025, Номер unknown

Опубликована: Апрель 2, 2025

Background: During the coronavirus disease 2019 (COVID-19) pandemic, changes in healthcare organisation may have affected management of chronic patients, such as those with type 2 diabetes (T2D), who require close monitoring. Although there are studies that analyse access and patients T2D Primary Care (PC) during is no synthesis results inform us about care provided. The aim this study to summarise existing evidence on provided PC settings COVID-19 well their follow-up outcomes, order understand impact pandemic management. Methods: A scoping review was conducted according approach described by Arksey O'Malley. Structured search strategies were developed for each selected databases (PubMed, EMBASE Web Science). We included articles published English Spanish up 30 November 2024 pandemic. Two independent reviewers screened titles abstracts select related population, intervention, outcomes interest. In cases disagreement, a third reviewer resolved discrepancy. One extracted data summarised them. Results: From total 441 articles, 19 full-text finally inclusion. Europe had highest number publications. majority retrospective cohort most commonly used source electronic health records. two topics interest identified: services regarding There general decrease face-to-face visits made T2D, reduced checks laboratory parameters, blood pressure weight. monitoring after not always worse previously obtained. Conclusions: without clear control highlighting importance virtual ensure continuity care. Protocol registration INPLASY202360057.

Язык: Английский

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A Review on Integrating the Circular Economy in Diabetic Appliances Manufacture and Management for Sustainable Healthcare

Circular Economy and Sustainability, Год журнала: 2025, Номер unknown

Опубликована: Май 22, 2025

Язык: Английский

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Managing Type 2 Diabetes during the COVID-19 Pandemic: An Investigation of Reddit Data using LDA Topic Modelling and VADER sEntiment Analysis (Preprint)

JMIR Formative Research, Год журнала: 2025, Номер 9, С. e51154 - e51154

Опубликована: Янв. 2, 2025

Type 2 diabetes (T2D) is a chronic disease that can be partially managed through healthy behaviors. However, the COVID-19 pandemic impacted how people T2D due to work and school closures social isolation. Moreover, individuals with were at increased risk of complications from experienced worsened mental health stress anxiety. This study aims synthesize emerging themes related behaviors living T2D, they affected during early stages by examining Reddit forums dedicated T2D. Data January 2018 March 2021, downloaded using Pushshift API; support vector machines used classify whether post was made in context pandemic. Latent Dirichlet allocation topic modelling performed identify topics discussion across entire dataset subsequent iteration specific Sentiment analysis VADER (Valence Aware Dictionary for Reasoning) algorithm assess attitudes towards From all posts, identified classified into following themes: managing lifestyle (sentiment score 0.25, 95% CI 0.25-0.26), blood glucose 0.19, 0.18-0.19), obtaining care 0.18-0.20), coping receiving 0.34, 0.33-0.35). Among COVID-19-specific poor 0.04, -0.01 to0.11), accessing doctor medications controlling 0.14, 0.09-0.20), changing food habits 0.20-0.31), impact on levels 0.03, -0.03 0.08), status employment insurance 0.17, 0.13-0.22), 0.09, 0.03-0.14). Overall, posts as COVID-19-related (0.12, 0.01-0.15) associated lower sentiment than those nonCOVID (0.25, 0.24-0.25). limited lack method assessing demographics users verifying had Themes data suggested significantly influenced their disease, particularly terms dealing virus. negatively demonstrates media qualitative source understanding patient perspectives.

Язык: Английский

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Changes in diabetes screening and exercise during the COVID-19 pandemic in adults with prediabetes

Diabetes Research and Clinical Practice, Год журнала: 2025, Номер 224, С. 112195 - 112195

Опубликована: Апрель 21, 2025

To evaluate changes in type 2 diabetes mellitus (T2DM) screening and exercise during the COVID-19 shelter-in-place, whether Medicaid patients racial/ethnic minoritized groups were disproportionally affected. Retrospective cohort study of 578,585 adults with prediabetes aged ≥ 18-89 years BMI 25 (≥23 if Asian) at Kaiser Permanente Northern California from January 2019 to December 2021. We used separate interrupted time-series analyses aggregated weekly T2DM rates, or mean minutes, any decrease associated shelter-in-place (March 19, 2020, June 1, 2020). Analyses performed 2023-2024. Before Covid, 121/10,000 patients/week screened for T2DM, exercised 107 min/week. Initially, dropped near zero (by ∼ 96 %) followed by a slow increase 7.4 (95 % CI: 2.4-12.4, p-value 0.004)/10,000 shelter-in-place. Similarly, decreased initially 37 (29-45, < 0.001) minutes/week, 3.5 (1.7-5.4, minutes/week These patterns similar across groups; however, took 1.5 resume baseline levels. The was an abrupt among prediabetes. Future mandates should support high-risk populations, especially Medicaid, maintain prevent progression.

Язык: Английский

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Incidence and prevalence of generalized pustular psoriasis in multiethnic Johor Bahru, Malaysia: a population-based cohort study using routinely captured electronic health records in the Teleprimary Care (TPC®) clinical information system from 2010 to 2020

British Journal of Dermatology, Год журнала: 2023, Номер 189(4), С. 410 - 418

Опубликована: Май 10, 2023

There is limited understanding of the epidemiology generalized pustular psoriasis (GPP) internationally, with no population-based estimates GPP in South East Asia.To determine incidence and prevalence Malaysian population characterize its flares trigger factors.We conducted a cohort study using Teleprimary Care database between January 2010 December 2020. We identified 230 dermatologist-confirmed cases International Classification Diseases, 10th revision, diagnostic codes. Annual rates were stratified by age, sex ethnicity. compared data regarding factors for patients who had associated vulgaris (PV) those did not have PV.The was 198 per million (267 women, 127 men) 27.2 person-years [95% confidence interval (CI) 22.8-31.6]; 35.3 (28.4-42.2) women 18.3 (13.1-23.5) men. Rates higher Chinese individuals [prevalence 271 million; 41.6 (28.9-54.3)] than Malay 186; 24.6 (19.4-29.7)] or Indian ethnic group 179; 25.0 (13.8-36.3)]. consistently men highest among population, followed populations. Overall, 67% PV. The without PV lower at 66 vs. 132 19.3 (95% CI 15.6-23.0) 8.0 5.6-10.3) person-years, respectively. mean age onset 42.7 years (SD 18.4). A bimodal trend observed, first second peaks 20-29 50-59 years, Disease significantly earlier [mean 37.5 20.7) 44.9 17.0), P = 0.026]. Flares occurred more frequently number patient year 1.35 0.77) 1.25 0.58), 0.039]. Common triggers infections, pregnancy, menstruation stress, whereas withdrawal therapy, particularly systemic corticosteroids, frequent also PV.Our findings contribute to global mapping GPP, which will help inform management this rare condition.

Язык: Английский

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Consistent service use before the COVID-19 pandemic predicted the continuity of face-to-face appointments during the lockdown among type 2 diabetes patients

Primary care diabetes, Год журнала: 2024, Номер 18(2), С. 230 - 237

Опубликована: Янв. 6, 2024

IntroductionThe COVID-19 pandemic affected diabetes care among type 2 (T2D) patients. However, it is not known whether the observed changes in concern all T2D patients equally. We examined health service usage and treatment outcomes according to pre-pandemic follow-up activity.MethodsWe analysed electronic records of 11 083 North Karelia, Finland (March 2017–March 2021), categorizing them by T2D-related in-person contact frequency. focused on HbA1c LDL measurement activity targets as indicators.ResultsOverall, recording rates for decreased during pandemic. They most but stayed at highest level with consistent face-to-face use, characterised proportion comorbidities elevated HbA1c. Their were negatively affected. In contrast, activities increased those no contact.ConclusionThose use greater needs more likely seek despite lockdown, negative effect was seen.

Язык: Английский

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Impact of coronavirus disease 2019 on medical practice in endocrine and metabolic diseases in Japan: a nationwide surveillance study conducted by the Japan Endocrine Society

Endocrine Journal, Год журнала: 2024, Номер 71(5), С. 499 - 514

Опубликована: Янв. 1, 2024

We investigated the impact of Coronavirus disease 2019 (COVID-19) pandemic on management endocrine and metabolic disorders in Japan. conducted a cross-sectional nationwide questionnaire survey targeting board-certified endocrinologists under auspices Japan Endocrine Society. The consisted multiple-choice questions open-ended responses. Out approximately 2,700 specialists, 528 (19.5%) opted to participate, suggesting high level interest COVID-19 among endocrinologists. study found that almost half participants had encountered cases following infection or vaccination. Conditions related thyroid diseases, glucose metabolism disorders/diabetes, hypothalamic-pituitary were particularly prevalent. Diabetes obesity identified as having rates severe fatalities due COVID-19. also highlighted challenges routine diagnosis treatment, emphasizing potential benefits combining remote consultations with in-person visits optimize frequency examinations check-ups during infectious outbreak which disrupts access healthcare providers. insights obtained from this are expected contribute ensuring appropriate provision for patients by using flexible consultation formats, even conditions where medical may be limited future outbreaks emerging re-emerging diseases.

Язык: Английский

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Impact of the COVID-19 Pandemic on Lifestyle Behavior and Clinical Care Pathway Management in Type 2 Diabetes: A Retrospective Cross-Sectional Study

Medicina, Год журнала: 2024, Номер 60(10), С. 1624 - 1624

Опубликована: Окт. 4, 2024

Background and Objectives: In Italy, as in the rest of world, government restrictions aimed at containing spread COVID-19 primarily imposed limitations on social relationships personal behavior. This situation significantly affected management chronic illnesses, including type 2 diabetes (T2D). The objective was to evaluate perceptions patients with T2D regarding quality care received during pandemic impact dietary physical activity behaviors. Materials Methods: We conducted a retrospective cross-sectional survey. Data were collected from June July 2023 using convenience sampling T2D, Patient Assessment Chronic Illness Care (PACIC) Medi-Lite questionnaires administered. Results: During research period, out 130 subjects who met all enrollment criteria, 103 included this study (79.23%). results administered heterogeneous. average scores PACIC Questionnaire for each question displayed significant variability, indicating range experiences care. survey, fruit, cereals, olive oil showed highest adherence levels, mean ranging 2.58 (SD ± 1.18) fruit 1.89 0.34) 1.97 0.17) cereals. Patients reported increased food intake lockdown attributed it having more time prepare meals. Physical levels remained unchanged 48 patients, decreased 45 only 9 managed exercise restrictions. Conclusions: Healthcare systems must prioritize comprehensive plans that address not health, but also emotional well-being. Post-pandemic, promoting healthier lifestyles empowering manage their condition is crucial. A multidisciplinary multidimensional approach could support vulnerable individuals, such especially crises like pandemics or other dramatic events.

Язык: Английский

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