Impact of the COVID-19 pandemic on the utilisation of health services at public hospitals in Yemen: a retrospective comparative study

Abstract

BackgroundThe COVID-19 pandemic has led to a global crisis, creating an unprecedented situation, which has taken the world by storm, overshadowing on all life’ aspects and having a significant impact on the health systems of most countries. In this study, the delivery of health services is investigated both before and during the outbreak of the COVID-19 pandemic at public hospitals in Yemen to assess the impact of COVID-19 on the utilisation of health services.MethodData collected from 127 hospitals in Yemen were reviewed using the DHIS2 system. The data represented 3 months before the outbreak of COVID-19 between January and March 2020 and during the outbreak of COVID-19 outbreak between April and June 2020. The results were then compared with the same period in 2019. The utilisation pattern of healthcare services during the period of investigation was compiled and analysed by applying a generalised estimating equation (GEE) to examine the effects of the COVID-19 outbreak in Yemen. The data collected from the targeted hospitals included information related to consultations, surgeries, deliveries, C-sections and penta-3rd dose immunisation.ResultsThe trendline of health services used during the pandemic showed a gradual decline beginning from April 2020 for consultations, surgeries and penta-3rd dose utilisation. The GEE model revealed a significant effect (p<0.05) during the outbreak compared with preoutbreak in the consultation services (B=−1,343.9; 95% CI −1,767.2 to −920.6; χ2=38.718), surgeries (B=−54.98; 95% CI −79.13 to −30.83, χ2=19.911) and penta-3rd dose (B=−24.47; 95% CI −30.56 to −18.38 and χ2=62.010). As for deliveries and C-sections, the results were shown to be statistically non-significant.ConclusionThe impact of COVID-19 on continuity of health services delivery in Yemen has been distinct and profound, where the study revealed that the number of the consultations, surgeries and number of vaccinated children have been declined during the COVID-19 pandemic, likely due to the partially lockdown measures taken and fear of being infected. However, the deliveries and C-section services remained nearly in the same level and did not affect by the COVID-19 pandemic.

Healthcare services utilization and seeking behaviour during COVID- 19 pandemic in the UAE – A cross-sectional study.

“…The ndings of this study reveal that slightly less than half of the respondents did not use healthcare services during the COVID-19 period. This nding is consistent with other studies that reported a reduction in health care utilization especially at the beginning of the pandemic [17][18][19][20][21]. This reduction in healthcare utilization can be partially explained by the limited mobility of the UAE population during the entire lockdown period that was imposed by the government.…”

Assessing capacities and resilience of health services during the COVID-19 pandemic: Lessons learned from use of rapid key informant surveys

“…In countries, the approach mitigated reporting burden and fostered cross-programme discussions, by offering one coordinated and comprehensive tool to assess different service areas. Moreover, to the extent that validation has been possible, the findings have echoed other studies that found consistent but variable impacts on essential health services across health domains ( 4 , 5 , 69 – 73 ).…”

“…The maintenance of essential health services during the corona virus disease of 2019 (COVID-19) pandemic has been critical, as disruptions to essential health services-including for health promotion, disease prevention, diagnosis, treatment, rehabilitation, and palliation-may lead to even greater adverse health outcomes than the pandemic itself, especially in vulnerable populations (1)(2)(3)(4)(5)(6)(7). However, throughout the pandemic, many countries have faced complex challenges that required accurate and timely data on facility capacities, service utilization, and community needs and preferences to inform the development of action plans and strategies to respond to COVID-19 while maintaining safe delivery of care.…”

Evaluation of the impact of the COVID-19 pandemic on health service utilization in China: A study using auto-regressive integrated moving average model

“…For example, a recent study from UK found that health service utilization decreased by 70% and respiratory system disease treatment services by 42% during the first wave of the pandemic. ( 9 ) Another study in Yemen reported a 10% reduction in surgery and a 4% decrease in medical consultation during the early phase of the pandemic in 2020 ( 16 ). Similar trends were observed in other countries, such as Armenia ( 17 ), Iran ( 18 ), and Italy ( 19 ).…”