Changes in Healthcare Utilization, Spending, and Perceived Health During Covid–19: A Longitudinal Study from Singapore

Ahn, SangNam; Kim, Seonghoon; Koh, Kanghyock

doi:10.2139/ssrn.3695416

Cited by 12 publications

(10 citation statements)

References 14 publications

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“…It set up a series of unprecedented major fundamental reorganizational actions, including dedicated Covid-19 wards and screening centers, scaled-up intensive and intermediary care units, postponed elective activities, and reduced outpatient consultations. Our findings using self-reports of forgone care are in line with hospitals' reports of decreased health care utilization (− 23% to − 49%) during the Covid-19 pandemic (Ahn et al, 2020). Our results are also in line with recent findings showing a high proportion of forgone care in other regions, especially among vulnerable individuals (e.g., unemployed people or people without health insurance) (Ke et al, 2021).…”

Section: Discussionsupporting

confidence: 92%

“…Clinical appointments and elective surgeries were cancelled or postponed to save health care resources and avoid the risk of viral transmission to health practitioners and patients (Negrini et al, 2020). Consequently, patients encountered delays in health care for the management of chronic diseases, emergency medicine, and preventive medicine (Ahn et al, 2020;Bruno and Rose, 2020;Cano-Valderrama et al, 2020;Feral-Pierssens et al, 2020;Lazzerini et al, 2020;Metzler et al, 2020). In addition, patients were reluctant to seek care because of a semi-lockdown and due to fear of contracting Covid-19, willingness to preserve health care resources, and unawareness of health services still being available (Lazzerini et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

“…In addition, patients were reluctant to seek care because of a semi-lockdown and due to fear of contracting Covid-19, willingness to preserve health care resources, and unawareness of health services still being available (Lazzerini et al, 2020). To date, most studies relied on hospital data with a focus on pediatrics and emergency care, rather than on patients' reports of forgoing health care (Ahn et al, 2020). Some recent studies showed a high proportion of forgone care (41% among US adults from March to mid-June 2020, Ke et al, 2021), but individual empirical data in countries with a universal health care coverage are still needed to achieve a better understanding of the problem.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Vulnerable patients forgo health care during the first wave of the Covid-19 pandemic

Baggio¹,

Vernaz²,

Spechbach³

et al. 2021

Preventive Medicine

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During the first wave of the Covid-19 pandemic, access to health care was limited, and patients encountered important delays for scheduled appointments and care. Empirical data relying on patients' reports of forgoing health care are scarce. This study investigated Covid-19-related self-reports of forgoing health care in a sample of vulnerable outpatients in Geneva, Switzerland. We collected data from 1167 adult outpatients, including clinically vulnerable patients (with chronic diseases), geriatric patients (involved in a health care network for people aged 60 or older), and socially vulnerable patients (involved in a migrant health program or a mobile outpatient community care center) in June 2020. Data on sociodemographic factors, forgoing health care, and anti-SARS-CoV-2 antibodies were collected. Of the patients, 38.5% reported forgoing health care. Forgoing health care was more frequent for younger patients, women, patients with a low level of education, and patients with a chronic disease ( p < .001). There was no significant association between the presence of anti-SARS-CoV-2 antibodies and forgoing health care ( p = .983). As the decrease in routine management of patients might have important and unpredictable adverse health consequences, avoiding delayed health care is crucial.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Vulnerable patients forgo health care during the first wave of the Covid-19 pandemic

Baggio¹,

Vernaz²,

Spechbach³

et al. 2021

Preventive Medicine

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“…This shown that the movement control order has somewhat restricted the access to healthcare facilities among the B40 group aged 40 years and above in Klang Valley. Other countries such as Singapore 23,24 and Hong Kong 25 have shown similar findings where the healthcare utilization were lower during the pandemic COVID-19. Study in US populations also shown that patients significantly reduced use of preventive and elective care and increased used of telemedicine.…”

Section: Discussionmentioning

confidence: 58%

The Covid Impact to Public Healthcare Utilization Among Urban Low-Income Subsidized Community in Klang Valley Malaysia

Yunus

Puteh

Ali

et al. 2021

Health Services Research and Managerial Epidemiology

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Background: Appropriate level of healthcare utilization is one of the aims in translating health system inputs into improving the outcome of population health. Healthcare utilization services in Malaysia remains relatively low as compared to the rate in most high-income countries and some gaps exist across socioeconomic status. After the financial handouts deemed Household Living Aid (HLA) to low-income earners, Malaysia has recently implemented a financial health protection scheme toward for low-income group known as PeKa B40 to improve their access for healthcare services. This study aims to determine the healthcare utilization among the low-income population living in urban Klang Valley, and to explore the relationship between healthcare utilization with the demographic characteristics of this population. Material and Methods: A cross-sectional study using face to face structured questionnaire. All 447 respondents included were low-income earners enrolled in the HLA. Chi-square analysis and multiple logistic regression were used to examine association between the risk factors and healthcare utilization. Results: The response rate was 93.5%. The healthcare utilization among the respondents during the partial lockdown period was 19.5% and 33.1% during the recovery lockdown period. Enrollment in the PeKa B40 scheme among the 7.6% respondents was not associated with healthcare utilization. After controlling for the variables, those aged 60 years and above [AOR: 1.87; 95% (CI): (1.07; 3.27)], self-rated poor health status [AOR: 2.16; 95% (CI): (1.07; 4.34)], having NCDs [AOR: 4.21; 95% (CI): (2.23; 7.94)], and being hospitalized in the past 12 months [AOR: 3.54; 95% (CI): (1.46; 8.62)], were more likely to utilize healthcare services as compared to their counterparts. Conclusion: The results from this study is valuable for policy recommendations to improve on the coverage of the PeKa B40 scheme and healthcare access for the low-income population especially during the pandemic.

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“…Another important challenge for UHC systems is to ensure that patients can have their healthcare needs met within the UHC-funded delivery system and do not need to seek care outside the system—so-called ‘leakage’—where members will incur increased out-of-pocket costs to receive care from providers that are outside the UHC delivery system. Finally, though not limited to countries with UHC systems, there is a growing literature that shows that many countries experienced significant declines in healthcare utilisation for both outpatient and inpatient services as related to the COVID-19 pandemic 8–12…”

Section: Introduction and Overviewmentioning

confidence: 99%

Utilisation, out-of-pocket payments and access before and after COVID-19: Thailand’s Universal Health Coverage Scheme

Damrongplasit,

Melnick

2024

BMJ Glob Health

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The goal of Universal Health Coverage (UHC) is that everyone needing healthcare can access quality services without financial hardship. Recent research covering countries with UHC systems documents the emergence, and acceleration following the COVID-19 pandemic of unapproved informal payment systems by providers that collect under-the-table payments from patients. In 2001, Thailand extended its ‘30 Baht’ government-financed coverage to all uninsured people with little or no cost sharing. In this paper, we update the literature on the performance of Thailand’s Universal Health Coverage Scheme (UCS) with data covering 2019 (pre-COVID-19) through 2021. We find that access to care for Thailand’s UCS-covered population (53 million) is similar to access provided to populations covered by the other major public health insurance schemes covering government and private sector workers, and that, unlike reports from other UHC countries, no evidence that informal side payments have emerged, even in the face of COVID-19 related pressures. However, we do find that nearly one out of eight Thailand’s UCS-covered patients seek care outside the UCS delivery system where they will incur out-of-pocket payments. This finding predates the COVID-19 pandemic and suggests the need for further research into the performance of the UHC-sponsored delivery system.

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Changes in Healthcare Utilization, Spending, and Perceived Health During Covid–19: A Longitudinal Study from Singapore

Cited by 12 publications

References 14 publications

Vulnerable patients forgo health care during the first wave of the Covid-19 pandemic

Vulnerable patients forgo health care during the first wave of the Covid-19 pandemic

The Covid Impact to Public Healthcare Utilization Among Urban Low-Income Subsidized Community in Klang Valley Malaysia

Utilisation, out-of-pocket payments and access before and after COVID-19: Thailand’s Universal Health Coverage Scheme

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