Objective: Methodological challenges for investigating the changes in healthcare utilization during COVID-19 pandemic must be considered for obtaining unbiased estimates. Study design and setting: A population-based study in the Lombardy region (Italy) measured the association between the level of epidemic restrictions (increasing exposure during pre-epidemic, post-lockdown, and lockdown periods) and the recommended healthcare (outcome) for patients with schizophrenia, heart failure, chronic obstructive pulmonary disease, breast cancer, and pregnancy women. Two designs are applied: the self-controlled case series (SCCS) and the usual cohort design. Adjustments for between-patients unmeasured confounders and seasonality of medical services delivering were performed. Results: Compared with pre-epidemic, reductions in delivering recommended healthcare during lockdown up to 73% (95% confidence interval: 63%–80%) for timeliness of breast cancer surgery, and up to 20% (16%–23%) for appropriated gynecologic visit during pregnancy were obtained from SCCS and cohort design, respectively. Healthcare provision came back to pre-epidemic levels during the post-lockdown, with the exception of schizophrenic patients for whom the SCCS showed a reduction in continuity of care of 11% (11%–12%). Conclusion: Strategies for investigating the changes in healthcare utilization during pandemic must be implemented. Recommendations for taking into account sources of systematic uncertainty are discussed and illustrated by using motivating examples.

Corrao, G., Cantarutti, A., Monzio Compagnoni, M., Franchi, M., Rea, F. (2022). Change in healthcare during Covid-19 pandemic was assessed through observational designs. JOURNAL OF CLINICAL EPIDEMIOLOGY, 142(February 2022), 45-53 [10.1016/j.jclinepi.2021.10.015].

Change in healthcare during Covid-19 pandemic was assessed through observational designs

Corrao G.;Cantarutti A.;Monzio Compagnoni M.;Franchi M.;Rea F.
2022

Abstract

Objective: Methodological challenges for investigating the changes in healthcare utilization during COVID-19 pandemic must be considered for obtaining unbiased estimates. Study design and setting: A population-based study in the Lombardy region (Italy) measured the association between the level of epidemic restrictions (increasing exposure during pre-epidemic, post-lockdown, and lockdown periods) and the recommended healthcare (outcome) for patients with schizophrenia, heart failure, chronic obstructive pulmonary disease, breast cancer, and pregnancy women. Two designs are applied: the self-controlled case series (SCCS) and the usual cohort design. Adjustments for between-patients unmeasured confounders and seasonality of medical services delivering were performed. Results: Compared with pre-epidemic, reductions in delivering recommended healthcare during lockdown up to 73% (95% confidence interval: 63%–80%) for timeliness of breast cancer surgery, and up to 20% (16%–23%) for appropriated gynecologic visit during pregnancy were obtained from SCCS and cohort design, respectively. Healthcare provision came back to pre-epidemic levels during the post-lockdown, with the exception of schizophrenic patients for whom the SCCS showed a reduction in continuity of care of 11% (11%–12%). Conclusion: Strategies for investigating the changes in healthcare utilization during pandemic must be implemented. Recommendations for taking into account sources of systematic uncertainty are discussed and illustrated by using motivating examples.
Articolo in rivista - Articolo scientifico
Cohort; Covid-19; Healthcare utilization database; Indirect burden; Recommendations; Self-controlled case series;
English
26-ott-2021
2022
142
February 2022
45
53
none
Corrao, G., Cantarutti, A., Monzio Compagnoni, M., Franchi, M., Rea, F. (2022). Change in healthcare during Covid-19 pandemic was assessed through observational designs. JOURNAL OF CLINICAL EPIDEMIOLOGY, 142(February 2022), 45-53 [10.1016/j.jclinepi.2021.10.015].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/362286
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