How do patients with chronic illnesses respond to a public health crisis? Evidence from diabetic patients in Japan during the COVID-19 pandemic

Abstract:: How do people change their healthcare behavior when a public health crisis occurs? Within a year of its emergence, coronavirus disease 2019 (COVID-19) has gradually infiltrated our lives and altered our lifestyles, including our healthcare behaviors. In Japan, which faces China across the...

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Autores principales:	Masataka Harada, Takumi Nishi, Toshiki Maeda, Kozo Tanno, Naoyuki Nishiya, Hisatomi Arima
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	COVID-19 Diabetes Doctor visits Japan Socioeconomic disparities Public aspects of medicine RA1-1270 Social sciences (General) H1-99
Acceso en línea:	https://doaj.org/article/de8715a6e5db44fd9fb4c46d227048df
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spelling	oai:doaj.org-article:de8715a6e5db44fd9fb4c46d227048df2021-11-24T04:32:22ZHow do patients with chronic illnesses respond to a public health crisis? Evidence from diabetic patients in Japan during the COVID-19 pandemic2352-827310.1016/j.ssmph.2021.100961https://doaj.org/article/de8715a6e5db44fd9fb4c46d227048df2021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2352827321002366https://doaj.org/toc/2352-8273Abstract:: How do people change their healthcare behavior when a public health crisis occurs? Within a year of its emergence, coronavirus disease 2019 (COVID-19) has gradually infiltrated our lives and altered our lifestyles, including our healthcare behaviors. In Japan, which faces China across the East China Sea and accepted 924,800 Chinese tourists in January 2020, the emergence and spread of COVID-19 provides a unique opportunity to study people's reactions and adaptations to a pandemic.Patients with chronic illnesses who require regular doctor visits are particularly affected by such crises. We focused on diabetic patients whose delay in routine healthcare invites life-threatening complications and examined how their patterns of doctor visits changed and how demographic, socioeconomic, and vital factors disparately affected this process. We relied on the insurance claims data of a health insurance association in Tokyo. By using panel data of diabetic patients from April 2018 to September 2020, we performed visual investigations and conditional logistic regressions controlling for all time-invariant individual characteristics.Contrary to the general notion that the change in healthcare behavior correlates with the actual spread of the pandemic, the graphical and statistical results both showed that diabetic patients started reducing their doctor visits during the early stage of the pandemic. Furthermore, a substantial decrease in doctor visits was observed in women, and large to moderate reductions were seen in patients who take insulin and are of advanced age, who are at high risk of developing severe COVID-19. By contrast, no differentiated effect was found in terms of income status. We further investigated why a change in pattern occurred for each subgroup.The patterns of routine healthcare revealed by this study can contribute to the improvement of communication with the target population, the delivery of necessary healthcare resources, and the provision of appropriate responses to future pandemics. (299 words).Masataka HaradaTakumi NishiToshiki MaedaKozo TannoNaoyuki NishiyaHisatomi ArimaElsevierarticleCOVID-19DiabetesDoctor visitsJapanSocioeconomic disparitiesPublic aspects of medicineRA1-1270Social sciences (General)H1-99ENSSM: Population Health, Vol 16, Iss , Pp 100961- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	COVID-19 Diabetes Doctor visits Japan Socioeconomic disparities Public aspects of medicine RA1-1270 Social sciences (General) H1-99
spellingShingle	COVID-19 Diabetes Doctor visits Japan Socioeconomic disparities Public aspects of medicine RA1-1270 Social sciences (General) H1-99 Masataka Harada Takumi Nishi Toshiki Maeda Kozo Tanno Naoyuki Nishiya Hisatomi Arima How do patients with chronic illnesses respond to a public health crisis? Evidence from diabetic patients in Japan during the COVID-19 pandemic
description	Abstract:: How do people change their healthcare behavior when a public health crisis occurs? Within a year of its emergence, coronavirus disease 2019 (COVID-19) has gradually infiltrated our lives and altered our lifestyles, including our healthcare behaviors. In Japan, which faces China across the East China Sea and accepted 924,800 Chinese tourists in January 2020, the emergence and spread of COVID-19 provides a unique opportunity to study people's reactions and adaptations to a pandemic.Patients with chronic illnesses who require regular doctor visits are particularly affected by such crises. We focused on diabetic patients whose delay in routine healthcare invites life-threatening complications and examined how their patterns of doctor visits changed and how demographic, socioeconomic, and vital factors disparately affected this process. We relied on the insurance claims data of a health insurance association in Tokyo. By using panel data of diabetic patients from April 2018 to September 2020, we performed visual investigations and conditional logistic regressions controlling for all time-invariant individual characteristics.Contrary to the general notion that the change in healthcare behavior correlates with the actual spread of the pandemic, the graphical and statistical results both showed that diabetic patients started reducing their doctor visits during the early stage of the pandemic. Furthermore, a substantial decrease in doctor visits was observed in women, and large to moderate reductions were seen in patients who take insulin and are of advanced age, who are at high risk of developing severe COVID-19. By contrast, no differentiated effect was found in terms of income status. We further investigated why a change in pattern occurred for each subgroup.The patterns of routine healthcare revealed by this study can contribute to the improvement of communication with the target population, the delivery of necessary healthcare resources, and the provision of appropriate responses to future pandemics. (299 words).
format	article
author	Masataka Harada Takumi Nishi Toshiki Maeda Kozo Tanno Naoyuki Nishiya Hisatomi Arima
author_facet	Masataka Harada Takumi Nishi Toshiki Maeda Kozo Tanno Naoyuki Nishiya Hisatomi Arima
author_sort	Masataka Harada
title	How do patients with chronic illnesses respond to a public health crisis? Evidence from diabetic patients in Japan during the COVID-19 pandemic
title_short	How do patients with chronic illnesses respond to a public health crisis? Evidence from diabetic patients in Japan during the COVID-19 pandemic
title_full	How do patients with chronic illnesses respond to a public health crisis? Evidence from diabetic patients in Japan during the COVID-19 pandemic
title_fullStr	How do patients with chronic illnesses respond to a public health crisis? Evidence from diabetic patients in Japan during the COVID-19 pandemic
title_full_unstemmed	How do patients with chronic illnesses respond to a public health crisis? Evidence from diabetic patients in Japan during the COVID-19 pandemic
title_sort	how do patients with chronic illnesses respond to a public health crisis? evidence from diabetic patients in japan during the covid-19 pandemic
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/de8715a6e5db44fd9fb4c46d227048df
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How do patients with chronic illnesses respond to a public health crisis? Evidence from diabetic patients in Japan during the COVID-19 pandemic

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