Impact of the COVID-19 pandemic on continuity of medical treatment for patients with chronic diseases in Japan: a retrospective cohort analysis
Abstract Background The COVID-19 pandemic has raised concerns about continuity of care for chronic diseases such as diabetes, hypertension, and dyslipidemia. Although studies have documented declines in healthcare utilization, few have assessed individual-level patterns of treatment interruption. Me...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-05-01
|
| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-025-12798-3 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849731883852627968 |
|---|---|
| author | Tomoki Ishikawa Akihito Kako Jumpei Sato Junko Hattori Hiromasa Yoshimoto Masaru Kitsuregawa Kazuo Goda Yoshimitsu Takahashi Takeo Nakayama Naohiro Mitsutake |
| author_facet | Tomoki Ishikawa Akihito Kako Jumpei Sato Junko Hattori Hiromasa Yoshimoto Masaru Kitsuregawa Kazuo Goda Yoshimitsu Takahashi Takeo Nakayama Naohiro Mitsutake |
| author_sort | Tomoki Ishikawa |
| collection | DOAJ |
| description | Abstract Background The COVID-19 pandemic has raised concerns about continuity of care for chronic diseases such as diabetes, hypertension, and dyslipidemia. Although studies have documented declines in healthcare utilization, few have assessed individual-level patterns of treatment interruption. Methods We conducted a retrospective cohort analysis using administrative claims data (2018–2021) from a Prefecture, Japan. Eligible patients were diagnosed with and prescribed medications for diabetes mellitus, hypertension, or dyslipidemia in January of 2019 or 2020 and followed until December of each year. The primary outcome was the time-to- interruption of physician visits, defined as a gap of at least 60 days between follow-up visits. We used Cox proportional hazards regression, adjusted for age, sex, comorbidities, and prior healthcare utilization, to compare the risk of treatment interruption in 2020 (COVID-19 group) vs. 2019 (pre-pandemic group). Sensitivity analyses were performed with thresholds of 30 and 90 days. Logistic regression examined whether pandemic-related interruptions were associated with the likelihood of returning to treatment within one year. Results A total of 410,911 patients met the inclusion criteria. Across all three chronic conditions, the hazard of interruption was significantly higher in 2020 than in 2019; adjusted HRs are 1.26 (95% CI = 1.17–1.36) for diabetes, 1.39 (95%CI = 1.31–1.47) for hypertension, and 1.24 (95%CI = 1.17–1.32) for dyslipidemia, respectively. No significant difference in resuming care was observed between the 2020 and 2019 interruptions (OR = 0.89; 95% CI = 0.81–1.09). Sensitivity analyses showed consistent findings, despite slight variations in hazard ratios for different gap thresholds. Conclusions The COVID-19 pandemic was associated with an increased risk of treatment interruption in patients with chronic diseases, underscoring the need for targeted strategies to maintain care continuity during public health emergencies. While older patients and those with multimorbidity showed earlier interruptions, the overall patterns persisted across disease groups, emphasizing the importance of preemptive measures and patient outreach to prevent delayed or forgone care. |
| format | Article |
| id | doaj-art-b2fb154430974fc0a58d0190d753edd0 |
| institution | DOAJ |
| issn | 1472-6963 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj-art-b2fb154430974fc0a58d0190d753edd02025-08-20T03:08:24ZengBMCBMC Health Services Research1472-69632025-05-0125111010.1186/s12913-025-12798-3Impact of the COVID-19 pandemic on continuity of medical treatment for patients with chronic diseases in Japan: a retrospective cohort analysisTomoki Ishikawa0Akihito Kako1Jumpei Sato2Junko Hattori3Hiromasa Yoshimoto4Masaru Kitsuregawa5Kazuo Goda6Yoshimitsu Takahashi7Takeo Nakayama8Naohiro Mitsutake9Institute for Health Economics and Policy, Association for Health Economics Research and Social Insurance and WelfareInstitute of Industrial Science, the University of TokyoInstitute of Industrial Science, the University of TokyoInstitute of Industrial Science, the University of TokyoInstitute of Industrial Science, the University of TokyoInstitute of Industrial Science, the University of TokyoInstitute of Industrial Science, the University of TokyoDepartment of Implementation Science in Public Health, Kyoto University School of Public HealthDepartment of Health Informatics, Graduate School of Medicine & School of Public Health, Kyoto UniversityInstitute for Health Economics and Policy, Association for Health Economics Research and Social Insurance and WelfareAbstract Background The COVID-19 pandemic has raised concerns about continuity of care for chronic diseases such as diabetes, hypertension, and dyslipidemia. Although studies have documented declines in healthcare utilization, few have assessed individual-level patterns of treatment interruption. Methods We conducted a retrospective cohort analysis using administrative claims data (2018–2021) from a Prefecture, Japan. Eligible patients were diagnosed with and prescribed medications for diabetes mellitus, hypertension, or dyslipidemia in January of 2019 or 2020 and followed until December of each year. The primary outcome was the time-to- interruption of physician visits, defined as a gap of at least 60 days between follow-up visits. We used Cox proportional hazards regression, adjusted for age, sex, comorbidities, and prior healthcare utilization, to compare the risk of treatment interruption in 2020 (COVID-19 group) vs. 2019 (pre-pandemic group). Sensitivity analyses were performed with thresholds of 30 and 90 days. Logistic regression examined whether pandemic-related interruptions were associated with the likelihood of returning to treatment within one year. Results A total of 410,911 patients met the inclusion criteria. Across all three chronic conditions, the hazard of interruption was significantly higher in 2020 than in 2019; adjusted HRs are 1.26 (95% CI = 1.17–1.36) for diabetes, 1.39 (95%CI = 1.31–1.47) for hypertension, and 1.24 (95%CI = 1.17–1.32) for dyslipidemia, respectively. No significant difference in resuming care was observed between the 2020 and 2019 interruptions (OR = 0.89; 95% CI = 0.81–1.09). Sensitivity analyses showed consistent findings, despite slight variations in hazard ratios for different gap thresholds. Conclusions The COVID-19 pandemic was associated with an increased risk of treatment interruption in patients with chronic diseases, underscoring the need for targeted strategies to maintain care continuity during public health emergencies. While older patients and those with multimorbidity showed earlier interruptions, the overall patterns persisted across disease groups, emphasizing the importance of preemptive measures and patient outreach to prevent delayed or forgone care.https://doi.org/10.1186/s12913-025-12798-3COVID‑19Chronic disease managementTreatment interruptionContinuity of careAdministrative claims data |
| spellingShingle | Tomoki Ishikawa Akihito Kako Jumpei Sato Junko Hattori Hiromasa Yoshimoto Masaru Kitsuregawa Kazuo Goda Yoshimitsu Takahashi Takeo Nakayama Naohiro Mitsutake Impact of the COVID-19 pandemic on continuity of medical treatment for patients with chronic diseases in Japan: a retrospective cohort analysis BMC Health Services Research COVID‑19 Chronic disease management Treatment interruption Continuity of care Administrative claims data |
| title | Impact of the COVID-19 pandemic on continuity of medical treatment for patients with chronic diseases in Japan: a retrospective cohort analysis |
| title_full | Impact of the COVID-19 pandemic on continuity of medical treatment for patients with chronic diseases in Japan: a retrospective cohort analysis |
| title_fullStr | Impact of the COVID-19 pandemic on continuity of medical treatment for patients with chronic diseases in Japan: a retrospective cohort analysis |
| title_full_unstemmed | Impact of the COVID-19 pandemic on continuity of medical treatment for patients with chronic diseases in Japan: a retrospective cohort analysis |
| title_short | Impact of the COVID-19 pandemic on continuity of medical treatment for patients with chronic diseases in Japan: a retrospective cohort analysis |
| title_sort | impact of the covid 19 pandemic on continuity of medical treatment for patients with chronic diseases in japan a retrospective cohort analysis |
| topic | COVID‑19 Chronic disease management Treatment interruption Continuity of care Administrative claims data |
| url | https://doi.org/10.1186/s12913-025-12798-3 |
| work_keys_str_mv | AT tomokiishikawa impactofthecovid19pandemiconcontinuityofmedicaltreatmentforpatientswithchronicdiseasesinjapanaretrospectivecohortanalysis AT akihitokako impactofthecovid19pandemiconcontinuityofmedicaltreatmentforpatientswithchronicdiseasesinjapanaretrospectivecohortanalysis AT jumpeisato impactofthecovid19pandemiconcontinuityofmedicaltreatmentforpatientswithchronicdiseasesinjapanaretrospectivecohortanalysis AT junkohattori impactofthecovid19pandemiconcontinuityofmedicaltreatmentforpatientswithchronicdiseasesinjapanaretrospectivecohortanalysis AT hiromasayoshimoto impactofthecovid19pandemiconcontinuityofmedicaltreatmentforpatientswithchronicdiseasesinjapanaretrospectivecohortanalysis AT masarukitsuregawa impactofthecovid19pandemiconcontinuityofmedicaltreatmentforpatientswithchronicdiseasesinjapanaretrospectivecohortanalysis AT kazuogoda impactofthecovid19pandemiconcontinuityofmedicaltreatmentforpatientswithchronicdiseasesinjapanaretrospectivecohortanalysis AT yoshimitsutakahashi impactofthecovid19pandemiconcontinuityofmedicaltreatmentforpatientswithchronicdiseasesinjapanaretrospectivecohortanalysis AT takeonakayama impactofthecovid19pandemiconcontinuityofmedicaltreatmentforpatientswithchronicdiseasesinjapanaretrospectivecohortanalysis AT naohiromitsutake impactofthecovid19pandemiconcontinuityofmedicaltreatmentforpatientswithchronicdiseasesinjapanaretrospectivecohortanalysis |