ArticleBMC health services research2025
Impact of the COVID-19 pandemic on continuity of medical treatment for patients with chronic diseases in Japan: a retrospective cohort analysis.
Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Association of Protocol Design-Related Factors With Enrollment Duration in Clinical Trials.Clinical and translational science · 2026Article
- Medical care cost dynamics during COVID-19 pandemic: financial implications for Japanese health insurance system.Health economics review · 2026Article
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10 authors.
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Abstract
backgroundThe 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.
methodsWe 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.
resultsA 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.
conclusionsThe 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.
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