Health Services and Policy
IDF2022-0948 Health Inequality and its link to HbA1c Test Recovery in a Developed Health Economy: In a ‘Nearly Post COVID-19’ World

https://doi.org/10.1016/j.diabres.2023.110489Get rights and content

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Background

We previously showed that in first 6 months of the UK COVID-19 (C19) pandemic, >6.6 m HbA1c tests were missed, including 1.4 m in people with diabetes (DM). Furthermore, C19 more significantly impacts people with DM and those from more deprived background.

Aim

To examine the variability in rate of recovery of HbA1c testing, and links to demographics, including deprivation status.

Method

We examined HbA1c tests across 7 UK sites (570 general practices; 4.57 m population) between Oct-17:Dec-21. We compared monthly tests during 4 periods: Apr-Jun20 (C19 Impact Period 1(CIP1)), Jul-Dec20 (Inter-Lockdown Recovery; ILR), Jan-Feb21 (CIP2) and Mar-Dec21 (Post-Lockdown Recovery; PLR), with the equivalent period in 2019.

We then examined effect of practice size/diabetes prevalence/proportion aged>65 years and deprivation score.

Results

For all 7 centres, monthly requests dropped by 85.2–89.4% of the mean monthly 2019 request numbers in Apr-20. During the following 3periods, degree of recovery to pre-pandemic levels/drop during CIP2, showed greater variability between centres (ILR: 74.0–93.2%, CIP2: 78.6–94.2%, PLR: 89.0–105.7%). No link between age/practice size/diabetes prevalence and post-pandemic recovery.

Return to pre-pandemic levels during the two recovery periods was associated with deprivation status. Compared with

Conclusion

C19 continues to have a major impact on diabetes management with some centres yet to return to pre-pandemic levels. This appears most significant in areas of greatest deprivation.

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