The Impact of COVID-19 Pandemic on Outpatient Visits for All-Cause and Chronic Diseases in Korea: A Nationwide Population-Based Study

Sim, Boram; Nam, Eun Woo

doi:10.3390/ijerph19095674

Cited by 13 publications

(8 citation statements)

References 30 publications

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“…The pandemic has challenged public health systems worldwide, revealing that even seemingly robust health systems can be rapidly overwhelmed and compromised ( 3 – 6 ). Health seeking behavior for routine care also declined during the COVID-19 pandemic ( 7 – 10 ). In the US, for example, the combination of increased workload and reduced number of health workers due to infection, fears about exposure, and burn-out, led to a severe strain on the capacity to maintain essential services ( 11 ).…”

Section: Introductionmentioning

confidence: 99%

The provision and utilization of essential health services in Afghanistan during COVID-19 pandemic

Neyazi

Lindan

Perdes³

et al. 2023

Front. Public Health

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IntroductionThe COVID-19 pandemic has disrupted provision of essential health services and overwhelmed even robust health systems worldwide. The Afghanistan health system has suffered both from the pandemic, as well as from political upheaval and regime change.MethodsWe evaluated essential service delivery using data collected from a cross-sectional survey of health care facilities in Afghanistan based on administration of a World Health Organization standardized assessment of frontline service readiness. A multi-stage sampling scheme was used to identify a representative sample of 92 health facilities (68 clinics and 24 hospitals) providing essential health services in five provinces. Facility managers were asked to report on changes in health service delivery in late 2021 and early 2022 (corresponding to the end of a significant national COVID-19 surge in infections) compared to the same period one year earlier.ResultsAmong health facilities evaluated; 29 were in urban and 63 were in rural settings. Most facilities reported an increase in the provision of outpatient care particularly in maternal and child health services as well as for tuberculosis, chronic respiratory diseases, mental health, and substance abuse; the number of in-patients also increased. In contrast, provision of services for malaria, neglected tropical diseases, and community outreach programs decreased. Nearly all facilities used strategies to maintain services, including targeting high-risk patients, promoting self-care, and redirecting patients to alternative health care sites. Nearly three fourth (70.6%) of facilities provided no training about COVID-19 to staff; only 65.2% referred COVID-19 patients to designated hospitals and 44.6% had safe transportation for these patients.DiscussionIncreased demand for services during this period was likely due to a backlog in need generated during the preceding COVID-19 surge and the political changes happened a few months earlier to this survey. Facilities used various methods to maintain services, although the decrease in provision of community outreach was concerning. Facilities appeared to be able to maintain essential health services, despite an increase in demand. However, awareness and training of COVID-19 protocols and appropriate and safe referrals need to be improved. In general, these series of surveys are informative and helpful to identify any changes in provision of essential health services and can facilitate recovery of health systems during and after pandemics.

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Section: Introductionmentioning

confidence: 99%

The provision and utilization of essential health services in Afghanistan during COVID-19 pandemic

Neyazi

Lindan

Perdes³

et al. 2023

Front. Public Health

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“…Consistent with reports across the World, a study conducted in Japan demonstrated a decrease in outpatient clinic prescriptions, with drugs for respiratory diseases most affected and antineoplastic least affected 41 , it correlates with other studies carried out in Japan that revealed a temporary decline in physician visit by patients with chronic conditions 42 . A study carried out in Korea reported a decline in outpatient visits for all cause and chronic diseases than was expected in 2020 43 , in this study there were discrepancies in clinic attendance amongst patients with different chronic diseases, the decline in outpatient visits were more pronounced in these with respiratory, neurological and liver diseases (11.5%,7.1% and 6.2%) respectively, it was less with diabetes, malignant neoplasm , heart disease, thyroid conditions and mental and behavioral disorders 43 . Several studies across Korea reported that the delay in seeking or avoid seeking care was for the fear of being infected by COVID-19 44,45 , this perceived risk fluctuated depending on the pandemic wave 46 .…”

Section: Impact On Health Care Settingsmentioning

confidence: 89%

A Review Article on Impact of Coronavirus Disease on Patients in the Health Care Setting: A Tale or Reality

Ozah

Akerele

Tagar

2023

MRAJ

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Background: Coronavirus disease had a devastating effect on the World, with significant disruption in healthcare, the burgeoning impact is still unfolding. The inequities and fragilities amongst nations particularly low and medium economic countries whose patients are dependent on out of pocket expenditure to access healthcare, has occasioned varied consequence of the pandemic on patients in the health care setting and it has reshaped how health care is practiced. Aims: The aim of this review article was to assess the impact of Coronavirus disease on health care utilization by non -COVID patient during the pandemic. Methods: The review article was carried out with a search engine focused on articles related to impact of Coronavirus disease published between December 2019 till date, which were identified and reviewed. Conclusion: The review article gave an insight to the significant disruptions in health care services amongst patients witnessed across countries of the world, the disparities in the disruptions were due to heterogeneity amongst nations, national policies and health policies during the pandemic and the socioeconomic realities that ensued. Outpatient services witnessed varying reduction across the globe ranging between 30-50%. Sub-Saharan Africa witnessed disruption as much as 50% depending on load of COVID-19 infection amongst populace. The reason for the interruptions across the world was the fear of contracting the disease, access to health care setting due to lock down and shortage of health care personnel, in addition in sub-Saharan Africa, the economic down turn occasioned by the pandemic reduced household income which in turn reduced expenditure on health since most countries were dependent on out of pocket expenditure to fund health care services. In-patient care was also not spared of the disruptions witnessed even though emergency care was prioritized. Overall, there was a reported reduction in admissions for respiratory diseases due to non- pharmacological measures aimed at stemming COVID-19 infection which was equally effective for other respiratory diseases. In some countries like United States the reduction in hospital admissions was paralleled by increasing mortality particularly amongst Hispanic blacks as more acute and severe cases were deemed to have presented for admissions. Surgical priority was maintaining emergency services and prioritization of cancer care, there was a measurable reduction in surgical procedures as elective surgeries were postponed or cancelled. Most laparoscopic and endoscopic procedures were cancelled because of the perceived notion that they are aerosol generating and could increase transmission of COVID-19 infection from asymptomatic carriers, however US jettisoned cancellation of its surgical procedures after 35 days considering that it could not cope. The psychosocial impact of the pandemic and health care access spiraled into increasing anxiety and depression for both health care workers and patients, while the fear of stigmatization was rife from contracting the disease. The consensus therefore was to strengthen adaptive measures and reconfigure health care to mitigate this impact in future pandemic, while allowing telehealth to take center stage.

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“…Research from the perspective of healthcare service supply also shows that relatively low-priority healthcare services for non-COVID-19 patients were postponed or canceled due to the surge in COVID-19 [ 41 ]. However, Korea may have experienced minimal impact in this regard because its healthcare system was not overwhelmed by the COVID-19 pandemic [ 42 ]. Nevertheless, the interval between outpatient visits may have increased because of changes in doctors’ practice.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the effect of the COVID-19 pandemic on hypertension and diabetes care in South Korea: an interrupted time series analysis

2023

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Background Access to healthcare services is important, especially for patients with chronic diseases. We evaluated the effect of the COVID-19 pandemic on outpatient visits and medication for patients with hypertension and diabetes in South Korea. Methods Nationwide claims data were extracted for patients with hypertension and diabetes from January 2019 to July 2020. We used an interrupted time series (ITS) analysis to evaluate the pandemic’s impact on outpatient care using the number of outpatient visits and days of medication supplied per visit. We identified the change in the continuity of care in medication, a consequence of the change in outpatient care, using the Medication Possession Ratio (MPR). Results The number of outpatient visits for diabetes significantly declined in February 2020, when community transmission began. However, when high-intensity social distancing was relaxed in April 2020, outpatient visits for hypertension and diabetes rebounded significantly. Moreover, when the outpatient visits declined, the number of days of medication supplied per visit increased. Consequently, the average MPRs significantly increased compared to 2019, increasing the ratio of patients with appropriate medication supply (MPR ≥ 0.8). Conclusions Outpatient visits decreased immediately when COVID-19 spread to local communities. However, the number of days of medication supplied per visit increased to compensate for the longer intervals between visits. Rather, the change in the continuity of care in medication improved; thus, the temporary decrease in outpatient visits might have had a limited negative impact on health outcomes.

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The Impact of COVID-19 Pandemic on Outpatient Visits for All-Cause and Chronic Diseases in Korea: A Nationwide Population-Based Study

Cited by 13 publications

References 30 publications

The provision and utilization of essential health services in Afghanistan during COVID-19 pandemic

The provision and utilization of essential health services in Afghanistan during COVID-19 pandemic

A Review Article on Impact of Coronavirus Disease on Patients in the Health Care Setting: A Tale or Reality

Evaluating the effect of the COVID-19 pandemic on hypertension and diabetes care in South Korea: an interrupted time series analysis

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