The impact of the COVID-19 pandemic on the oncology services demand in a middle-income setting with universal health insurance
Abstract
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. In addition, 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 reduction 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 reduction in 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.
Authors
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Keywords
- Coronavirus infections
- neoplasms
- health services needs and demand
- Colombia
- oncology service hospital
Author Biographies
, Centro Javeriano de Oncología - Hospital Universitario San Ignacio
https://orcid.org/0000-0002-4656-6064
, Centro Javeriano de Oncología - Hospital Universitario San Ignacio
https://orcid.org/0000-0003-1053-9731
, Departamento Medicina Interna – Hospital Universitario San Ignacio
https://orcid.org/0000-0002-5388-8192
, Facultad de Medicina – Pontificia Universidad Javeriana
https://orcid.org/0000-0002-0658-4268
, Centro Javeriano de Oncología - Hospital Universitario San Ignacio
https://orcid.org/0000-0002-5150-3041
, Centro Javeriano de Oncología - Hospital Universitario San Ignacio
https://orcid.org/0000-0002-2241-3020
, Centro Javeriano de Oncología - Hospital Universitario San Ignacio
https://orcid.org/0000-0001-7187-9946
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