Healthcare Seeking and Mortality of Patients with Diabetes during the COVID-19 Pandemic in Colombia: a Nationwide Study

Introduction: Besides the direct health implications of COVID-19, the pandemic and its containment measures have had multiple negative consequences, especially in the prevention and treatment of chronic diseases. This paper aimed to evaluate the effects of COVID-19 pandemic on mortality rates and healthcare seeking among individuals with diabetes in Colombia. Methods: Nationwide ecological panel study of secondary data from the Colombian official records of mortality and medical attentions due to diabetes between 2015 and 2021. Aggregated data of hospitalizations, ambulatory and emergency care visits, as well as death rates due to diabetes were assessed once adjusted by health care infrastructure and rurality. Results: During the COVID-19 pandemic, the mortality rate from diabetes increased by 30.4% (pre-pandemic average by semester: 7.73 deaths per 100,000 inhabitants; pandemic average: 10.08 deaths per 100,000 inhabitants), the average rate of medical attention increased by 67.2% (pre-pandemic: 3163 per 100.000; pandemic: 5290 per 100.000), in which, ambulatory care arose by 44.6% and hospitalizations by 42.3%. Rurality was inversely associated with health visits, and the availability of tertiary care institutions was associated with both diabetes mortality and consultations. Conclusions: An important increase in total number of consultations and mortality rates on diabetes patients was observed during the COVID-19 crisis in Colombia. Availability of high specialized health facilities is related to the number of medical consultations, which suggests that people that did not have access to specialized health services were neglected. Actual impact of COVID-19 pandemic in patients with diabetes remains unclear.