The road to recovery: impact of COVID-19 on healthcare utilization in South Korea in 2016–2022 using an interrupted time-series analysis

Yoo, Katelyn Jison; Lee, Yoonkyoung; Lee, Seulbi; Friebel, Rocco; Shin, Soon-ae; Lee, Taejin; Bishai, David

doi:10.1016/j.lanwpc.2023.100904

Cited by 12 publications

(10 citation statements)

References 37 publications

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“… 3 4 5 However, the reduction in healthcare facility utilization itself during the COVID-19 pandemic may have acted as a contributing factor to the even lower detection rates of respiratory viruses. 16 …”

Section: Discussionmentioning

confidence: 99%

Epidemiology of Respiratory Viruses in Korean Children Before and After the COVID-19 Pandemic: A Prospective Study From National Surveillance System

Cho,

Rhee,

Kang

et al. 2024

J Korean Med Sci

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Background The coronavirus disease 2019 (COVID-19) pandemic led to a decrease in the seasonal incidence of many respiratory viruses worldwide due to the impact of nonpharmaceutical interventions (NPIs). However, as NPI measures were relaxed, respiratory viral infections re-emerged. We aimed to characterize the epidemiology of respiratory viruses in Korean children during post-COVID-19 pandemic years compared to that before the pandemic. Methods A nationwide prospective ongoing surveillance study has been conducted for detection of respiratory viruses between January 2017 and June 2023. We included data on adenovirus (AdV), human bocavirus (HBoV), human coronavirus (HCoV), human metapneumovirus (HMPV), human rhinovirus (HRV), influenza virus (IFV), parainfluenza virus (PIV), and respiratory syncytial virus (RSV), which were detected in children and adolescents younger than 20 years. We analyzed the weekly detection frequency of individual viruses and the age distribution of the affected children. The study period was divided into prepandemic (2017–2019) and postpandemic (2021–2023) periods. Results A total of 19,589 and 14,068 samples were collected in the pre- and postpandemic periods, respectively. The overall detection rate of any virus throughout the study period was 63.1%, with the lowest occurring in the 2nd half of 2020 (50.6%) and the highest occurring in the 2nd half of 2021 (72.3%). Enveloped viruses (HCoV, HMPV, IFV, PIV, and RSV) almost disappeared, but nonenveloped viruses (AdV, HBoV, and HRV) were detected even during the peak of the COVID-19 pandemic. The codetection rate increased from 15.0% prepandemic to 19.1% postpandemic ( P < 0.001). During the postpandemic period, a large out-of-season PIV and HMPV epidemic occurred, but the usual seasonality began to be restored in 2023. The mean age of children with each virus detected in 2023 was significantly greater than that in prepandemic years ( P = 0.003 and 0.007 for AdV and HCoV, respectively; P < 0.001 for others). The mean age of children with IFV increased in 2022 (11.1 ± 5.2 years) from prepandemic years (7.9 ± 4.6 years) but decreased to 8.7 ± 4.1 years in 2023. Conclusion With the relaxation of NPI measures, several seasonal respiratory viruses cocirculated with unusual seasonal epidemic patterns and were associated with increasing age of infected children.

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Section: Discussionmentioning

confidence: 99%

Epidemiology of Respiratory Viruses in Korean Children Before and After the COVID-19 Pandemic: A Prospective Study From National Surveillance System

Cho,

Rhee,

Kang

et al. 2024

J Korean Med Sci

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“…In contrast, some experts insisted that medical costs seemed to be substantially reduced; ultimately, the COVID-19 pandemic resulted in economic burdens for patients with certain diseases or older patients [ 48 ]. Considering our findings that medical costs increased inversely with the significant decrease in the number of admissions, the financial loss due to COVID-19 has been immense and has threatened the financial stability of vulnerable individuals [ 46 , 47 , 49 ]. In addition, outpatient medical expenses for pancreatic, lung, breast, liver, and other types of cancer increased compared to the same period the previous year.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, South Korea is implementing ’essential healthcare’ policies in response to a shortage of specialized personnel for COVID-19. The primary goal of ’essential healthcare’ is to emphasize the accessibility of medical services in residential areas [ 49 , 50 ]. This emphasis has been particularly crucial in regions where healthcare utilization was significantly impacted during the period of epidemic spread, especially evident in certain areas, consistent with our results.…”

Section: Discussionmentioning

confidence: 99%

Impact of coronavirus disease 2019 on cancer care: How the pandemic has changed cancer utilization and expenditures

Sim,

Shin,

Lee

et al. 2024

PLoS ONE

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Purpose Since identified in December 2019, the novel coronavirus disease 2019 (COVID-19) has had a global impact on medical resource use and costs for patients with cancer in South Korea. This study aimed to identify the medical use and costs among patients with cancer during the COVID-19 pandemic, to predict these patterns in South Korea in the future. Methods We conducted a secondary claims data analysis using the National Health Insurance Service database for the calendar period of 2019–2020. Monthly relative percent changes in cancer incidence, medical use, and billing costs for medical care utilization by cancer type were calculated. Then, the medical use and costs after January 2020 were predicted using a time series model with data before the COVID-19 outbreak (2014–2019). Results The incidence of cancer diagnoses has seen a notable decline since the outbreak of the COVID-19 in 2020 as compared to 2019. Despite the impact of COVID-19, there hasn’t been a distinct decline in outpatient utilization when compared to inpatient utilization. While medical expenses for both inpatient and outpatient visits have slightly increased, the number of patients treated for cancer has decreased significantly compared to the previous year. In June 2020, overall outpatient costs experienced the highest increase (21.1%), while individual costs showed the most significant decrease (-4.9%) in June 2020. Finally, the number of hospitalisations and outpatient visits increased slightly from June–July in 2020, reducing the difference between the actual and predicted values. The decrease in the number of inpatient hospitalisations (-22~-6%) in 2020 was also high. Conclusions The overall use of medical services by patients with cancer decreased in 2020 compared with that in the pre-COVID-19 pandemic period. In the future, the government should consider how to recover from the COVID-19 pandemic, and establish permanent health policies for patients with cancer.

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“…As a fundamental part of the Plan, the Korea Central Cancer Registry (KCCR) publishes cancer registration statistics every year. In contrast to 2020, when the number of cancer cases decreased due to the coronavirus disease 2019 (COVID-19) pandemic, the number of cancer cases increased in 2021 as access to healthcare recovered [ 3 , 4 ]. The impact of reduced healthcare utilization, not only in Korea but worldwide due to COVID-19, on cancer diagnosis and treatment needs to be examined more closely in the coming years [ 3 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…In contrast to 2020, when the number of cancer cases decreased due to the coronavirus disease 2019 (COVID-19) pandemic, the number of cancer cases increased in 2021 as access to healthcare recovered [ 3 , 4 ]. The impact of reduced healthcare utilization, not only in Korea but worldwide due to COVID-19, on cancer diagnosis and treatment needs to be examined more closely in the coming years [ 3 , 5 ]. In this study, we report the most recent nationwide statistics on cancer incidence, survival, prevalence, and mortality, and their temporal trends.…”

Section: Introductionmentioning

confidence: 99%

Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2021

Park,

Jung,

Park

et al. 2024

Cancer Res Treat

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Purpose The current study provides national cancer statistics and their secular trends in Korea, including incidence, mortality, survival, and prevalence in 2021.Materials and Methods Incidence, survival, and prevalence rates of cancer were calculated using the Korea National Cancer Incidence Database, from 1999 to 2021, with survival follow-up until December 31, 2022. Deaths from cancer were assessed using causes-of-death data obtained from Statistics Korea.Results The number of new cancer diagnoses in 2021 increased by 27,002 cases (10.8%) compared to 2020. In 2021, newly diagnosed cancer cases and deaths from cancer were reported as 277,523 (age-standardized rate [ASR], 289.3 per 100,000) and 82,688 (ASR, 67.6 per 100,000), respectively. The overall cancer incidence rates increased by 3.3% annually from 1999 to 2012, and decreased by 5.3% from 2012 to 2015, thereafter, followed by non-significant changes. Cancer mortality rates have been decreasing since 2002, with more rapid decline in recent years (annual decrease of 2.8% from 2002 to 2013; 3.2% from 2013 to 2021). The 5-year relative survival between 2017 and 2021 was 72.1%, which contributed to prevalent cases reaching over 2.4 million in 2021.Conclusion In 2021, the number of newly diagnosed cancer patients increased as healthcare utilization recovered from the coronavirus disease 2019–related declines of 2020. Revised cancer registration guidelines expanded the registration scope, particularly for stomach and colorectal cancer. Survival rates have improved over the years, leading to a growing population of cancer survivors, necessitating a comprehensive cancer control strategy. The long-term impact of the pandemic on cancer statistics requires future investigation.

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The road to recovery: impact of COVID-19 on healthcare utilization in South Korea in 2016–2022 using an interrupted time-series analysis

Cited by 12 publications

References 37 publications

Epidemiology of Respiratory Viruses in Korean Children Before and After the COVID-19 Pandemic: A Prospective Study From National Surveillance System

Epidemiology of Respiratory Viruses in Korean Children Before and After the COVID-19 Pandemic: A Prospective Study From National Surveillance System

Impact of coronavirus disease 2019 on cancer care: How the pandemic has changed cancer utilization and expenditures

Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2021

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