IDF21-0194 Impact of COVID-19 during period of Level 3 alert on access to diabetes care in central Taiwan

Abstract

Background: On May 19, Taiwan's Central Epidemic Command Center announced that in response to the recent surge in the number of indigenous coronaviruses disease 2019 (COVID-19) cases, it will raise its epidemic warning to Level 3 nationwide from May 19 to July 26; the public is urged to continue to abide by and cooperate with Level 3 epidemic prevention and control measures. The COVID-19 pandemic caused a halt to in-person ambulatory care. Aim: We evaluated how the reduction in access to care affected diabetes outpatient care. Method: We performed a historical cohort study that involved reviewing electronic medical records (health record databases with Asus digital platforms) of patients with diabetes mellitus, treated at the Chung-Shan Medical University Hospital in Taichung, which is a central city Taiwan. We first identified patients for whom a visit was available during Level 3 Alert from May to June 2021 and then identified patients seen in 2019 and 2020 in the same month to match for seasonal variations in access to the clinic. Results: Overall, the number of visits (on-site or online) performed in the Level 3 COVID-19 Alert period was 28% lower, while diabetes outpatient reduction was 9% lower than in the same month of the previous 2 years. HbA1c testing volume was reduced by as much as 7% compared to the same month of the previous 2 years. HbA1c values did not increased during the period of level 3 compared to the same month of the previous 2 years, 7.16, 7.2 and 7.12%, respectively. Discussion: Health services access was affected, but with less extent in diabetes outpatient. HbA1c values were minimally affected. Although health services delivery may have been modified and adapted, people with diabetes in central Taiwan were able in managing their health and medications Level 3 alert period.