Impact of the COVID-19 Pandemic on NCD Clinic’s Quality Improvement, Service Delivery and Outcomes at Community Hospitals in Thailand
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Abstract
BACKGROUND: COVID-19 pandemic control measures are already well known for their impact on the health services system and limitations on access to care, especially among non-communicable patients that need continuation of care.
OBJECTIVES: To determine the impact of the COVID-19 pandemic on NCD clinic’s quality improvement, NCD clinic’s service delivery, patient service access, and clinical outcomes.
METHODS: This was a cross-sectional study. Secondary data were collected from quality improvement assessment results reported by NCD clinic at community hospitals in Thailand during 2019-2021, including six elements of quality improvement consisting of health care organization, clinical information systems, delivery system design, self-management support, decision support, and community linkage. Data for NCD clinic’s service delivery were collected from a 2021 online survey that was conducted to explore the impact of the COVID-19 pandemic on the service delivery of NCD clinic. The patient’s service access and clinical outcome data was collected from the health data center. Data were analyzed by descriptive and One-way ANOVA statistics.
RESULTS: The results of quality improvement assessment found that the community hospitals improved the quality of diabetic and hypertensive care in all elements and each element, increasing statistically between 2019 and 2021. However, there was no difference in delivery system design or decision support between 2020 and 2021. Some service deliveries were limited as follows; home health care, referral for chronic complication care, eye and foot exam, screening mental health and self-management support. The patient’s service access and clinical outcomes that were impacted were blood pressure controllable in diabetic patients and complications screening access.
CONCLUSIONS: It appears that the COVID-19 pandemic has had little effect on NCD clinic’s quality improvement. Therefore, limitations of some service deliveries such as complication screening, home health care, and referral system breakdown may contribute to delays in care, health outcomes and quality of life in the long run.
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