TY - JOUR
T1 - Israeli COVID lockdowns mildly reduced overall use of preventive health services, but exacerbated some disparities
AU - Rose, Adam J.
AU - Ein Mor, Eliana
AU - Krieger, Michal
AU - Ben-Yehuda, Arie
AU - Cohen, Arnon D.
AU - Matz, Eran
AU - Bar-Ratson, Edna
AU - Bareket, Ronen
AU - Paltiel, Ora
AU - Calderon-Margalit, Ronit
N1 - Publisher Copyright:
© 2022 The Author(s). Published by Oxford University Press on behalf of International Society for Quality in Health Care. All rights reserved.
PY - 2022/9/16
Y1 - 2022/9/16
N2 - Background: During 2020, Israel experienced two COVID-19-related lockdowns that impacted the provision of primary and secondary preventive care. Methods: We examined the month-by-month performance of selected preventive care services using data from Israel's national Quality Indicators in Community Healthcare program. Process of care measures included hemoglobin A1c (HbA1c) testing, cholesterol testing, colon cancer screening and mammography. Intermediate outcome measures included low-density lipoprotein control and HbA1c control. Measures were stratified by sex and by area-level socioeconomic position (SEP). Diabetes and mammography are presented in this abstract due to space limitations. Results: Annual HbA1c testing among persons with diabetes decreased from 90.9% in 2019 to 88.0% in 2020. Performance of HbA1c tests during lockdown months was as low as half the usual amount. There were compensatory increases in testing during post-lockdown months that did not quite make up for the missed tests. In 2019, 9.0% of Israelis with diabetes had poor glycemic control (HbA1c ≥ 9.0); in 2020, it was 8.8%. In total, 4.5% fewer mammograms were performed in 2020 compared with 2019. Women in the lowest SEP level performed 10.4% fewer mammograms in 2020 than in 2019, while women in the highest SEP level performed 3.1% more mammograms. Conclusions: Prolonged COVID lockdowns in 2020 were associated with marked decreases in the performance of preventive health services during those months. Compensatory spikes following the end of lockdowns partly, but did not completely, make up for the missed care. COVID lockdowns may have exacerbated socioeconomic disparities in some preventive health services.
AB - Background: During 2020, Israel experienced two COVID-19-related lockdowns that impacted the provision of primary and secondary preventive care. Methods: We examined the month-by-month performance of selected preventive care services using data from Israel's national Quality Indicators in Community Healthcare program. Process of care measures included hemoglobin A1c (HbA1c) testing, cholesterol testing, colon cancer screening and mammography. Intermediate outcome measures included low-density lipoprotein control and HbA1c control. Measures were stratified by sex and by area-level socioeconomic position (SEP). Diabetes and mammography are presented in this abstract due to space limitations. Results: Annual HbA1c testing among persons with diabetes decreased from 90.9% in 2019 to 88.0% in 2020. Performance of HbA1c tests during lockdown months was as low as half the usual amount. There were compensatory increases in testing during post-lockdown months that did not quite make up for the missed tests. In 2019, 9.0% of Israelis with diabetes had poor glycemic control (HbA1c ≥ 9.0); in 2020, it was 8.8%. In total, 4.5% fewer mammograms were performed in 2020 compared with 2019. Women in the lowest SEP level performed 10.4% fewer mammograms in 2020 than in 2019, while women in the highest SEP level performed 3.1% more mammograms. Conclusions: Prolonged COVID lockdowns in 2020 were associated with marked decreases in the performance of preventive health services during those months. Compensatory spikes following the end of lockdowns partly, but did not completely, make up for the missed care. COVID lockdowns may have exacerbated socioeconomic disparities in some preventive health services.
KW - COVID-19
KW - healthcare disparities
KW - quality of health care
UR - http://www.scopus.com/inward/record.url?scp=85138459448&partnerID=8YFLogxK
U2 - 10.1093/intqhc/mzac071
DO - 10.1093/intqhc/mzac071
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C2 - 36062971
AN - SCOPUS:85138459448
SN - 1353-4505
VL - 34
JO - International Journal for Quality in Health Care
JF - International Journal for Quality in Health Care
IS - 3
M1 - mzac071
ER -
