Impact of general restrictions on medical care
The Covid-19 pandemic has influenced every area of medicine. One of the major impacts has been restricted access to medical care4. In Poland, similar to other countries, patients’ access to general practitioners during the pandemic was limited and most consultations were done through telemedicine, which has a higher risk of an incorrect diagnosis5. Many hospitals around the world have been transformed into Covid-19 treating institutions, which means that patients are less likely to be accurately diagnosed and treated in a timely manner when the disease is still in early stages6. Nevertheless, cancer centres in many countries have remained open, with adequate restrictions while other hospitals were responsible for treating only patients with Covid-19. In fact, this approach allowed cancer centres in those countries to treat more patients during the pandemic than in the prior year6,7. We observed similar results, as evidenced by the 22% increase in the number of patients discussed at the MTB. In Poland, as in other countries, many hospitals were transformed into Covid-treating institutions, but this did not affect many cancer centres, including ours. Outpatient visits decreased by 50% from March to June 2020 and by 25% thereafter. Even so, most patients were able to schedule a consultation and receive a treatment proposal. By contrast, some high volume cancer centres experienced a substantial reduction in patients in the most acute phase of the pandemic, with one centre (MD Anderson) in the United States reporting a 25% decrease over a 6-week period 8.
In the context of limited access to medical care due to pandemic-related restrictions, the distance from the patient’s home to the hospital could be an important factor. To evaluate the impact of distance, we divided our patients into two groups: those living in the same province (Wielkopolska) as the hospital and those residing outside of this province. That analysis showed that the percentage of patients from the relatively large Wielkopolska province (30 000 m2) remained essentially unchanged from the pre-pandemic period (81% vs. 84%, respectively). To our knowledge, the only other study to examine this issue was performed by Kiong et al. at the MD Anderson Cancer Center, who did not find any significant differences either8.