Spillover Effects of COVID-19 on Essential Chronic Care and Ways to Foster Health System Resilience to Support Vulnerable Non-COVID Patients: A Multistakeholder Study.
Abstract
<h4>Objectives</h4>Little empirical research exists on how key stakeholders involved
in the provision of care for chronic conditions and policy planning perceive the indirect
or "spillover" effects of the COVID-19 on non-COVID patients. This study aims to explore
stakeholder experiences and perspectives of the impact of COVID-19 on the provision
of care for chronic conditions, evolving modalities of care, and stakeholder suggestions
for improving health system resilience to prepare for future pandemics.<h4>Design</h4>Qualitative
study design.<h4>Setting and participants</h4>This study was conducted during and
after the COVID-19 lockdown period in Singapore. We recruited a purposive sample of
51 stakeholders involved in care of non-COVID patients and/or policy planning for
chronic disease management. They included health care professionals (micro-level),
hospital management officers (meso-level), and government officials (macro-level).<h4>Methods</h4>In-depth
semi-structured interviews were conducted. All interviews were digitally recorded,
transcribed verbatim, and thematically analyzed.<h4>Results</h4>Optimal provision
of care for chronic diseases may be compromised through the following processes: lack
of "direct" communication between colleagues on clinical cases resulting in rescheduling
of patient visits; uncertainty in diagnostic decisions due to protocol revision and
lab closure; and limited preparedness to handle non-COVID patients' emotional reactions.
Although various digital innovations enhanced access to care, a digital divide exists
due to uneven digital literacy and perceived data security risks, thereby hampering
wider implementation. To build health system resilience, stakeholders suggested the
need to integrate digital care into the information technology ecosystem, develop
strategic public-private partnerships for chronic disease management, and give equal
attention to the provision of holistic psychosocial and community support for vulnerable
non-COVID patients.<h4>Conclusions and implications</h4>Findings highlight that strategies
to deliver quality chronic care for non-COVID patients in times of public health crisis
should include innovative care practices and institutional reconfiguration within
the broader health system context.
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https://hdl.handle.net/10161/24184Published Version (Please cite this version)
10.1016/j.jamda.2021.11.004Publication Info
Yoon, Sungwon; Goh, Hendra; Chan, Angelique; Malhotra, Rahul; Visaria, Abhijit; Matchar,
David; ... Ong, Marcus EH (2021). Spillover Effects of COVID-19 on Essential Chronic Care and Ways to Foster Health
System Resilience to Support Vulnerable Non-COVID Patients: A Multistakeholder Study.
Journal of the American Medical Directors Association. 10.1016/j.jamda.2021.11.004. Retrieved from https://hdl.handle.net/10161/24184.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Tazeen Hasan Jafar
Research Professor of Global Health
David Bruce Matchar
Professor of Medicine
My research relates to clinical practice improvement - from the development of clinical
policies to their implementation in real world clinical settings. Most recently my
major content focus has been cerebrovascular disease. Other major clinical areas in
which I work include the range of disabling neurological conditions, cardiovascular
disease, and cancer prevention. Notable features of my work are: (1) reliance on
analytic strategies such as meta-analysis, simulation, decision analy
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