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. 2022 Sep 16;34(3):mzac071.
doi: 10.1093/intqhc/mzac071.

Israeli COVID lockdowns mildly reduced overall use of preventive health services, but exacerbated some disparities

Adam J Rose  1   2 , Eliana Ein Mor  1   2 , Michal Krieger  1   2 , Arie Ben-Yehuda  3   2 , Arnon D Cohen  4   2 , Eran Matz  5   2 , Edna Bar-Ratson  6   2 , Ronen Bareket  7   2 , Ora Paltiel  1   2   3 , Ronit Calderon-Margalit  1   2
Affiliations

Israeli COVID lockdowns mildly reduced overall use of preventive health services, but exacerbated some disparities

Adam J Rose et al. Int J Qual Health Care. .

Abstract

Background: During 2020, Israel experienced two COVID-19-related lockdowns that impacted the provision of primary and secondary preventive care.

Methods: We examined the month-by-month performance of selected preventive care services using data from Israel's national Quality Indicators in Community Healthcare program. Process of care measures included hemoglobin A1c (HbA1c) testing, cholesterol testing, colon cancer screening and mammography. Intermediate outcome measures included low-density lipoprotein control and HbA1c control. Measures were stratified by sex and by area-level socioeconomic position (SEP). Diabetes and mammography are presented in this abstract due to space limitations.

Results: Annual HbA1c testing among persons with diabetes decreased from 90.9% in 2019 to 88.0% in 2020. Performance of HbA1c tests during lockdown months was as low as half the usual amount. There were compensatory increases in testing during post-lockdown months that did not quite make up for the missed tests. In 2019, 9.0% of Israelis with diabetes had poor glycemic control (HbA1c ≥ 9.0); in 2020, it was 8.8%. In total, 4.5% fewer mammograms were performed in 2020 compared with 2019. Women in the lowest SEP level performed 10.4% fewer mammograms in 2020 than in 2019, while women in the highest SEP level performed 3.1% more mammograms.

Conclusions: Prolonged COVID lockdowns in 2020 were associated with marked decreases in the performance of preventive health services during those months. Compensatory spikes following the end of lockdowns partly, but did not completely, make up for the missed care. COVID lockdowns may have exacerbated socioeconomic disparities in some preventive health services.

Keywords: COVID-19; healthcare disparities; quality of health care.

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Figures

Figure 1
Figure 1
Monthly hemoglobin A1c testing among persons with diabetes, 2019 vs. 2020.
Figure 2
Figure 2
Monthly number of mammograms among women, ages 50–75, 2020 vs. 2019.
See this image and copyright information in PMC

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