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Colombia Médica
versión On-line ISSN 1657-9534
Resumen
ZULUAGA PATINO, María et al. The impact of the COVID-19 pandemic on the oncology services demand in a middle-income setting with universal health insurance. Colomb. Med. [online]. 2022, vol.53, n.1, e2065115. Epub 30-Mar-2022. ISSN 1657-9534. https://doi.org/10.25100/cm.v53i1.5115.
Aim:
We analyze the impact of the COVID-19 pandemic on oncology service demand in a middle-income country with universal health coverage.
Methods:
We collected data from January 1st-2017 to December 31th-2021 at a reference center in Bogotá-Colombia regarding first-time consultations of cross-cutting services (clinical oncology, hematology, palliative care, radiation oncology); specialized multidisciplinary units (breast, prostate, lung, stomach); inpatient and outpatient systemic therapy; radiotherapy; oncology surgery; and bone marrow transplant. A descriptive time series analysis was performed, estimating monthly percent change and endemic channels.
Results:
Starting the confinement (April 2020), a general decrease in service demand was observed (R: -14.9% to -90.0%), with an additional but lower decrease in August 2020 coinciding with the first pandemic wave (R: -11.3% to -70.0%). Follow-up visits and ambulatory treatment showed no consistent reductions. New patients’ consultations for cross-cutting services had a speedy recovery (1 month), but clinical oncology, specialized units, and in-hospital treatment resumed more slowly. Only breast and stomach cancer showed a sustained reduction in early-stage disease. Women and older patients had a more significant reductionin service demand.
Conclusion: Despite no changes in service supply, the confinement induced a significant reduction in service demand. Variations by cancer type, service type, and population demographics deserve careful consideration for a suitable response to the emergency. The speedy recovery and the absence of a significant decrease during subsequent waves of the pandemic suggest patient resiliency and a lower impact than expected in middle-income settings in the presence of universal health insurance.
Palabras clave : Coronavirus infections; neoplasms; health services needs and demand; hospital oncology service; Colombia.