Impact of the early phase of the COVID-19 pandemic on the use of mental health services in South Korea: a nationwide, health insurance data-based study

Abstract

Purpose The coronavirus disease 2019 (COVID-19) pandemic has profoundly affected the utilization of mental health services. Existing evidence investigating this issue at the nationwide level is lacking, and it is uncertain whether the effects of the COVID-19 pandemic on the use of psychiatric services differs based on psychiatric diagnosis. Methods Data from the claims database between October 2015 and August 2020 was obtained from the Health Insurance Review and Assessment agency in South Korea. Based on the main diagnostic codes, psychiatric patients were identified and categorized into diagnostic groups (anxiety disorders, bipolar and related disorders, depressive disorders, and schizophrenia spectrum disorders). We calculated the number of psychiatric inpatients and outpatients and the medication adherence of patients for each month. We compared the actual and predicted values of outcomes during the COVID-19 pandemic and performed interrupted time-series analyses to test the statistical significance of the impact of the pandemic. Results During the COVID-19 pandemic, the number of inpatients and admissions to psychiatric hospitals decreased for bipolar and related disorders and depressive disorders. In addition, the number of patients admitted to psychiatric hospitals for schizophrenia spectrum disorders decreased. The number of psychiatric outpatients showed no significant change in all diagnostic groups. Increased medication adherence was observed for depressive, schizophrenia spectrum, and bipolar and related disorders. Conclusions In the early phase of the COVID-19 pandemic, there was a trend of a decreasing number of psychiatric inpatients and increasing medication adherence; however, the number of psychiatric outpatients remained unaltered.

The Impact of COVID-19 on Mental Healthcare Utilization in Switzerland Was Strongest Among Young Females—Retrospective Study in 2018–2020

“…Psychiatric inpatient admissions that decreased during the first shutdown also recovered quickly after the relief of the measures, similar to observations from Canada [15] and Italy [40] and faster than in South Africa [17] and South Korea [18]. Importantly, the decrease in psychiatric inpatient admissions during the first shutdown was comparable to that of general emergency inpatient procedures but considerably smaller than that of general elective inpatient procedures in Switzerland [36].…”

“…At the same time, the pandemic has affected the provision of mental healthcare, particularly in the beginning of the pandemic and in periods with many COVID-19 cases when healthcare services had to be reorganized in order to reduce the spread of the virus and to ensure care capacities for people with COVID-19. Accordingly, decreases in different forms of mental healthcare utilization, especially during shutdown periods, have been reported, e.g., in hospitalizations and/or emergency department visits for mental health diagnoses [15][16][17][18], presentations for or diagnoses of mental health conditions in primary care [19,20], and general population antidepressant drug purchase [21]. However, some studies also reported increases for certain mental healthcare utilization outcomes as the pandemic progressed, e.g., increases in antidepressants fillings in the general population [22] or in mental health outpatient visits especially among children and adolescents in the summer of 2020 [9,23].…”

Impact of the COVID-19 pandemic on adult mental health-related admissions at a large university health system in North Carolina – one year into the pandemic

“…Data on ED and hospital admissions for psychiatric disorders during the pandemic remain inconsistent with the majority of studies conducted internationally. For example, the studies from Europe, UK, Australia, South Korea and Canada variably reported both increases or decreases in visits [7][8][9][10][11][12][13][14][15][16][17][18]. In the United States, there were inconsistent and limited data on ED visits and admissions for adults in Midwest, rural areas of West Texas, urban Kentucky and New York City as well [19][20][21][22].…”