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Challenges in access to care among diabetes patients during COVID-19 pandemic: A hospital based mixed method study
1
Public Health Promotion and Development Organization Nepal
2
Public Health Promotion and Development Organization
3
Bergen Centre for Ethics and Priority Setting in Health, Department of Global Public Health and Primary Care, University of Bergen Norway
4
Bergen Centre for Ethics and Priority Setting in Health, Department of Global Public Health and Primary Care, University of Bergen Nepal
Publication date: 2023-04-26
Popul. Med. 2023;5(Supplement):A1505
ABSTRACT
Background:
The COVID-19 pandemic challenged the capacity of health system to deliver essential health services worldwide, including Nepal. Hindrances in access to care had substantial impact on people suffering from chronic non-communicable diseases (NCDs), and the most critical cases of COVID-19 were found among those with co-morbid. We aimed to identify challenges of diabetes mellitus (DM) patients in accessing health care during COVID-19 pandemic.
Methods:
We conducted a hospital-based cross-sectional study using a mixed-method approach in two hospitals in Kathmandu, Nepal and interviewed 134 participants employing structured questionnaire in August - September 2021. Further, we conducted in-depth interview with patients (10) and key informant interview with service providers (5). Study received ethical approval from the national Ethical Review Board at Nepal Health Research Council. Quantitative data was analyzed using descriptive statistics. The audio records of qualitative interviews were transcribed, translated, and analyzed using thematic analysis.
Results:
Many DM-patients struggled to access care, and 14% participants reported they were unable to get healthcare needed in previous two months. Among them, nearly 60% reported COVID-19 pandemic to be the cause. People from low socio-economic background, with chronic diseases, particularly elderly, and from rural areas were the ones most affected. Hindrance on follow up visits, delay in seeking care, fear of COVID-19 transmission and shortage of medications were reported as main challenges. With fear of COVID-19 transmission many regular follow-up was missed; some reported later with very low sugar level and some with very high endangering them of severe complications.
Conclusion:
Access to care for people with DM was affected due to COVID-19 pandemic with the effects mostly noticed among people from low-socioeconomic background. Distance modalities such as telemedicine and mHealth would help maintain the required access to care for patients with chronic NCDs such as DM during such emergencies.
The COVID-19 pandemic challenged the capacity of health system to deliver essential health services worldwide, including Nepal. Hindrances in access to care had substantial impact on people suffering from chronic non-communicable diseases (NCDs), and the most critical cases of COVID-19 were found among those with co-morbid. We aimed to identify challenges of diabetes mellitus (DM) patients in accessing health care during COVID-19 pandemic.
Methods:
We conducted a hospital-based cross-sectional study using a mixed-method approach in two hospitals in Kathmandu, Nepal and interviewed 134 participants employing structured questionnaire in August - September 2021. Further, we conducted in-depth interview with patients (10) and key informant interview with service providers (5). Study received ethical approval from the national Ethical Review Board at Nepal Health Research Council. Quantitative data was analyzed using descriptive statistics. The audio records of qualitative interviews were transcribed, translated, and analyzed using thematic analysis.
Results:
Many DM-patients struggled to access care, and 14% participants reported they were unable to get healthcare needed in previous two months. Among them, nearly 60% reported COVID-19 pandemic to be the cause. People from low socio-economic background, with chronic diseases, particularly elderly, and from rural areas were the ones most affected. Hindrance on follow up visits, delay in seeking care, fear of COVID-19 transmission and shortage of medications were reported as main challenges. With fear of COVID-19 transmission many regular follow-up was missed; some reported later with very low sugar level and some with very high endangering them of severe complications.
Conclusion:
Access to care for people with DM was affected due to COVID-19 pandemic with the effects mostly noticed among people from low-socioeconomic background. Distance modalities such as telemedicine and mHealth would help maintain the required access to care for patients with chronic NCDs such as DM during such emergencies.
| ISSN: | 2654-1459 |
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