The change of healthcare service in patients with inflammatory bowel disease in China during the epidemic: a national multicenter cross-sectional study based on a web-based questionnaire (Preprint)

BACKGROUND The epidemic of COVID-19 has been ongoing for more than 2 years since December 2019. OBJECTIVE The change of healthcare service in Chinese patients with inflammatory bowel disease under the dynamic zero-COVID strategy need to be investigated to optimize the management of patients. METHODS We conducted a nationwide, multicenter cross-sectional study based on a web-based questionnaire to compare the healthcare service during the epidemic. RESULTS 1001 questionnaires were included in the study. The ongoing epidemic impacted 37.5% patients on their treatment, and the biggest problem was unable to follow up timely(77.9%). There was no significant change in healthcare costs in Crohn’s disease(CD)(P = 0.695) and a significant increase in ulcerative colitis (UC)(P = 0.004) after the outbreak. Both UC and CD had an increase in the number of visits(UC 5.07 vs 4.54, P=0.001; CD 6.30 vs 5.76, P=0.002), hospitalizations(UC 1.30 vs 1.02, P＜0.001; CD 3.55 vs 2.78, P＜0.001), and hospitalization rates(UC 42.8% vs 40.2%, P=0.423; CD 75.8% vs 67.8%, P=0.004) after the outbreak. The rate of biologics had significant increased(UC 11.2% vs 17.7%, P=0.005; CD 53.2% vs 71.0%, P< 0.001). The proportion of people using online consultation increased from 41.6% to 55.1%(P< 0.001). 82.8% patients preferred face-to-face visits. CONCLUSIONS Recurrent outbreaks and the regular epidemic prevention and control policy had a long-term impact on medicalcare service for IBD patients. The preferred mode of healthcare was still face-to-face visit. It will be a long way to go in the construction of telemedicine in China. CLINICALTRIAL Chinese Clinical Trial Registry，ChiCTR2100044391，http://www.chictr.org.cn/showproj.aspx?proj=122505