Project description:While the impact of the coronavirus disease (COVID-19) pandemic on health inequalities is documented, oral health has been absent from this discussion. This commentary highlights the potential impacts of the COVID-19 pandemic on oral health inequalities in England in February 2021. It includes a literature review, Public Health England and Kantar Worldpanel sales data on health behaviours and analysis of NHS dental services data. Purchasing data indicate, except for smoking, increases in health-compromising behaviours. Since the resumption of dental services, NHS general dental service use modestly recovered among adults but not children by October 2020. There are clear inequalities among children and older adults, with more deprived groups having lower uptake of dental service use than more affluent groups. Oral cancer referrals and hospital admissions for tooth extractions in children dramatically declined, with the latter primarily affecting children in more deprived areas. Many oral health programmes in schools and care homes were disrupted or suspended throughout this period. All these indicate that oral health inequalities have widened due to the COVID-19 pandemic. An oral health plan of action requires prioritising long-term investment in public health programmes and transforming commissioning pathways to support those with the greatest needs to access oral healthcare services.
Project description:AimThis study investigates the perceived accessibility of healthcare services among older adults in Lithuania during the COVID-19 pandemic. The study is significant as it sheds light on geographical, organizational, and financial healthcare access issues encountered by the older population.MethodsConducted in January 2024, the study involved an anonymous questionnaire survey of 1,503 Lithuanian residents aged 65 and older.ResultsThe most frequently utilized healthcare services were consultations with a general practitioner (75.4%) 22.0% of respondents reported not receiving any healthcare services. 53.5% respondents were satisfied with travel time to specialists. Common challenges included difficulties in getting appointments with specialists (53.9%) and dentists (36.2%). Financial barriers led to unmet healthcare needs: 12.6% of the respondents did not receive needed services, 12.8% did not undergo recommended tests, and 14.2% did not purchase prescribed medications. Healthcare services were less accessible to elders with lower education, lower incomes, and those who self-rated health poorly (p < 0.05).ConclusionMost respondents received the healthcare they needed during the pandemic and rated geographical access positively. However, some problems in organizational and financial access were disclosed. The observed social gradient indicates that socioeconomic factors significantly influence healthcare access, potentially increasing vulnerability among certain groups.
Project description:ObjectivesHealthcare utilization decreased during the COVID-19 pandemic, likely due to reduced transmission of infections and healthcare avoidance. Though various investigations have described these changing patterns in children, most have analyzed specific care settings. We compared healthcare utilization, prescriptions, and diagnosis patterns in children across the care continuum during the first year of the pandemic with preceding years.Study designUsing national claims data, we compared enrollees under 18 years during the pre-pandemic (January 2016 -mid-March 2020) and pandemic (mid-March 2020 through March 2021) periods. The pandemic was further divided into early (mid-March through mid-June 2020) and middle (mid-June 2020 through March 2021) periods. Utilization was compared using interrupted time series.ResultsThe mean number of pediatric enrollees/month was 2,519,755 in the pre-pandemic and 2,428,912 in the pandemic period. Utilization decreased across all settings in the early pandemic, with the greatest decrease (76.9%, 95% confidence interval [CI] 72.6-80.5%) seen for urgent care visits. Only well visits returned to pre-pandemic rates during the mid-pandemic. Hospitalizations decreased by 43% (95% CI 37.4-48.1) during the early pandemic and were still 26.6% (17.7-34.6) lower mid-pandemic. However, hospitalizations in non-psychiatric facilities for various mental health disorders increased substantially mid-pandemic.ConclusionHealthcare utilization in children dropped substantially during the first year of the pandemic, with a shift away from infectious diseases and a spike in mental health hospitalizations. These findings are important to characterize as we monitor the health of children, can be used to inform healthcare strategies during subsequent COVID-19 surges and/or future pandemics, and may help identify training gaps for pediatric trainees. Subsequent investigations should examine how changes in healthcare utilization impacted the incidence and outcomes of specific diseases.
Project description:BackgroundDuring the COVID-19 pandemic, concern has been raised about suicide risk among healthcare workers (HCWs). We investigated the incidence risk and prevalence of suicidal thoughts and behaviour (STB), and their relationship with occupational risk factors, among National Health Service HCWs in England between April 2020 and August 2021.MethodsIn this longitudinal study, we analysed online survey data completed by 22,501 HCWs from 17 NHS Trusts at baseline (Time 1) and six months (Time 2). The primary outcome measures were suicidal ideation, suicide attempts, and non-suicidal self-injury. We used logistic regression to investigate the relationship between these outcomes and demographic characteristics and occupational factors. Results were stratified by occupational role (clinical/non-clinical).ResultsTime 1 and Time 2 surveys were completed by 12,514 and 7,160 HCWs, respectively. At baseline, 10.8% (95% CI = 10.1%, 11.6%) of participants reported having experienced suicidal thoughts in the previous two months, whilst 2.1% (95% CI = 1.8%, 2.5%) of participants reported having attempted suicide over the same period. Among HCWs who had not experienced suicidal thoughts at baseline (and who completed the Time 2 survey), 11.3% (95%CI = 10.4%, 12.3%) reported such thoughts six months later. Six months after baseline, 3.9% (95% CI = 3.4%, 4.4%) of HCWs reported attempting suicide for the first time. Exposure to potentially morally injurious events, lack of confidence about raising safety concerns and these concerns being addressed, feeling unsupported by managers, and providing a reduced standard of care were all associated with increased suicidal ideation among HCWs during the COVID-19 pandemic. At six months, among clinicians, a lack of confidence about safety concerns being addressed, independently predicted suicidal ideation.ConclusionSuicidal thoughts and behaviour among healthcare workers could be reduced by improving managerial support and enhancing the ability of staff to raise safety concerns.
Project description:To understand and analyse the global impact of COVID-19 on outpatient services, inpatient care, elective surgery, and perioperative colorectal cancer care, a DElayed COloRectal cancer surgery (DECOR-19) survey was conducted in collaboration with numerous international colorectal societies with the objective of obtaining several learning points from the impact of the COVID-19 outbreak on our colorectal cancer patients which will assist us in the ongoing management of our colorectal cancer patients and to provide us safe oncological pathways for future outbreaks.
Project description:The pervasive effects of the novel coronavirus (COVID-19) have put the world to test. Its effects permeate all facets of life including healthcare services and food supplies. However, most empirical studies failed to investigate its effects on the prices of food and healthcare services, which by all standards, are essential commodities. On this background, this study evaluates the impact of COVID-19 reported cases and lockdown stringency measures on the food and healthcare prices in the six (6) worst-affected countries. For empirical purposes, daily prices of food and healthcare services between 22nd January and 31st December 2020 were regressed against daily cases of COVID-19 and lockdown stringency measures within the dynamic autoregressive distributed lag procedure. Empirical evidences reveal that prices of healthcare and food are cointegrated with COVID-19 cases and lockdown measures in all the selected countries except Italy. Equally, healthcare and food prices reinforced itself in the long-run in the US, the UK and France. Furthermore, COVID-19 cases lead to significant increases in food and healthcare prices in the US, whereas, food and healthcare prices in France and UK declined significantly as COVID-19 cases mount. Conversely, food and healthcare prices declined significantly in the US and soar in France and the UK in reactions to COVID-19 new cases. Likewise, government stringency measures and containment health measures contributed significantly to healthcare and food price hike in the US and France respectively. Meanwhile, healthcare and food prices in the other selected countries remained unaffected even as the pandemic ravages. Following this empirical discoveries, relevant policy guidelines have been communicated.
Project description:BackgroundThere is concern about the impact of COVID-19, and the control measures to prevent the spread, on children's mental health. The aim of this work was to identify if there had been a rise of childhood suicide during the COVID pandemic.MethodUsing data from England's National Child Mortality Database (NCMD) the characteristics and rates of children dying of suicide between April and December 2020 were compared with those in 2019. In a subset (1st January to 17th May 2020) further characteristics and possible contributing factors were obtained.ResultsA total of 193 likely childhood deaths by suicide were reported. There was no evidence overall suicide deaths were higher in 2020 than 2019 (RR 1.09 (0.80-1.48), p = 0.584) but weak evidence that the rate in the first lockdown period (April to May 2020) was higher than the corresponding period in 2019 (RR 1.56 (0.86-2.81), p = 0.144). Characteristics of individuals were similar between periods. Social restrictions (e.g. to education), disruption to care and support services, tensions at home and isolation appeared to be contributing factors.LimitationsAs child suicides are fortunately rare, the analysis is based on small numbers of deaths with limited statistical power to detect anything but major increases in incidence.ConclusionWe found no consistent evidence that child suicide deaths increased during the COVID-19 pandemic although there was a possibility that they may have increased during the first UK lockdown. A similar peak was not seen during the following months, or the second lockdown.