The indirect impact of COVID-19 pandemic on chronic disease care in Hong Kong

Abstract

Background: The COVID-19 pandemic has disrupted routine health services for people with chronic diseases. Methods: We conducted 15 cross-sectional telephone surveys among adults in Hong Kong on alternate weeks from June 09 until December 30, 2020. Data on respondents’ socioeconomic characteristics, including age, occupation, education, and household income were collected. Calls were made using random digit dialling to landline and mobile numbers (1:1 ratio) during working and non-working hours to avoid overrepresentation of non-working groups. We performed multivariable logistic regression to assess factors associated with difficulty in accessing health care or medications. Results: Among 1,828 respondents, 54.1% of participants had hypertension and 23.4% had diabetes. The proportion of participants who reported increased difficulty in accessing health care or medication was 8%. Among participants with chronic disease, 11% reported difficulty accessing treatment and 9% experienced worsening chronic disease symptoms. Older age groups were less likely to experience difficulty in accessing care or medications during the COVID-19 pandemic (odds ratio: 0.40, 95% confidence interval: 0.16, 0.98). Loss of income (odds ratio: 1.13, 95% confidence interval: 0.69-1.83) and low household income (odds ratio: 1.16, 95% confidence interval: 0.73, 1.84) were associated with increased difficulty in accessing care, while receiving government financial support seemed to be protective (odds ratio 0.90, 95% confidence interval: 0.5-1.5). Conclusions: Younger (working age) people were more likely to report difficulty in accessing care demonstrating the widespread impact of the pandemic and control measures beyond traditionally vulnerable groups.