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The COVID-19 pandemic led to declines in in-person consultations and substantial increases in telemedicine use in many countries. This paper investigates whether this pattern occurred in Colombia using data for people with particular health conditions prior to the pandemic (rheumatoid arthritis, hemophilia, chronic kidney disease, HIV, and cancer). The study shows that healthcare utilization by people in Colombia with these conditions dropped significantly during the first months of the pandemic relative to the average of the previous two years. However, by the end of 2020, the rate of healthcare utilization had almost reached pre-pandemic levels. While the number of services fell for people in both the contributive and subsidized scheme, the share of people who had any contacts with healthcare providers each month declined substantially for those in the subsidized scheme and by a statistically insignificant amount for those in the contributive scheme. Declines in utilization and contacts for in-person consultations were partially offset by the increased use of telemedicine services which accounted for almost one-fifth of healthcare contacts by December 2020. Of the main explanations for healthcare disruptions, the diversion of healthcare resources to treat COVID-19 patients does not seem to have been as significant as changes in social mobility and government lockdown policies. These findings have a variety of implications for public policy, including: the need to address the causes of healthcare utilization declines among individuals in the subsidized scheme; the importance of incorporating better social communication and adjustments to lockdown policies when planning for future health emergencies; the value of expanding telemedicine, not only during emergencies but also during normal times; and the potential benefits from improving the quality and availability of administrative data so that future research can contribute more effectively to policies that promote greater equity and effectiveness in Colombian healthcare services.

Objective To describe the demographic and clinical manifestations of patients with chronic kidney disease (CKD), arterial hypertension, and/or diabetes mellitus, and to determine the association between the presence of these pathologies and the development of CKD. Methods Analytic and cross-sectional study. The information, with a cutoff date of 30 June 2013, comes from the integrated database of CKD and patients with hypertension and diabetes, which the Colombian payer entities provided to the national fund for high-cost diseases (Cuenta de Alto Costo). A descriptive analysis was conducted and the prevalence of CKD and stage 5 CKD was determined. Crude odds ratios (OR) were used to determine the association between CKD and age, sex, and diabetes. Results 2,599,419 records were analyzed, of which 40% corresponded to people with CKD. Overall, 74.9% of the population had hypertension and 6.4% had diabetes. The prevalence of CKD was 2.81%, with 94.3% of patients in stages 1 to 3. In patients with diabetes, the risk of presenting CKD is 1.03 (confidence interval of 95% [CI95%] 1.016-1.043). Among persons over 60 years of age, the risk of CKD is 2.15 (CI95% 2.140-2.167). Conclusions 33.4% of patients with hypertension or diabetes have not been studied to determine the presence or absence of CKD. It is a priority to implement strategies for secondary and primary prevention in order to prevent the progression of CKD and reduce the prevalence of risk factors such as hypertension and diabetes.

RESUMEN Objetivo El objetivo de este estudio fue describir las características demográficas y clínicas de los pacientes con enfermedad renal crónica (ERC), hipertensión arterial o diabetes mellitus y encontrar la asociación entre la presencia de estas patologías y el desarrollo de ERC. Métodos Estudio analítico y de corte transversal. La información procede de la base de datos única de ERC y de pacientes con hipertensión arterial y diabetes, que las entidades obligadas a compensar suministraron a la Cuenta de Alto Costo, reportada con corte al 30 de junio de 2013. Se realizó un análisis descriptivo y se determinó la prevalencia de ERC y enfermedad renal crónica en estadio 5 (ERC5). Se determinó la asociación entre ERC y edad, sexo y la diabetes mediante odds ratio (OR) crudos. Resultados Se analizaron 2 599 419 registros, de los cuales 40% correspondían a personas con ERC. El 74,9% de la población tenía hipertensión y 6,4% tenía diabetes. La prevalencia de ERC fue de 2,81%, y 94,3% de los pacientes se encontraba en estadios 1 a 3. El riesgo de presentar ERC en los pacientes con diabetes es 1,03 (intervalo de confianza de 95% [IC95%] 1,016 – 1,043). En los mayores de 60 años, el riesgo de ERC es 2,15 (IC95% 2,140 – 2,167). Conclusiones El 33,4% de pacientes con hipertensión o diabetes no han sido estudiados para determinar la presencia o ausencia de ERC. Es prioritario aplicar estrategias de prevención secundaria y primaria, para evitar la progresión de ERC y reducir la prevalencia de factores de riesgo como hipertensión y diabetes.