Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 11 9 2022 09 01 Impact of the COVID-19 Pandemic on Outpatient Service in Primary Healthcare Institutions: An Inspiration From Yinchuan of China 1926 1933 4113 10.34172/ijhpm.2021.119 EN Lu Xu Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China 0000-0002-7359-7683 Lin Zhuo Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China 0000-0001-9188-702X Jie Zhang Maternal and Child Health Care Hospital of Ningxia Hui Autonomous Region, Yinchuan, China 0000-0003-2747-3556 Wu Yang Maternal and Child Health Care Hospital of Ningxia Hui Autonomous Region, Yinchuan, China 0000-0003-1345-5568 Guozhen Liu Peking University Health Information Technology Co. Ltd, Beijing, China 0000-0003-4272-7331 Siyan Zhan Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing, China 0000-0001-7252-5349 Shengfeng Wang Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China 0000-0001-9397-0409 Huijie Xiao Department of Paediatrics, Peking University First Hospital, Beijing, China 0000-0001-8212-4186 Journal Article 2021 03 12 Background The coronavirus disease 2019 (COVID-19) pandemic has posed a great challenge to the healthcare system. This study evaluated the impact of the pandemic on the utilization of primary healthcare (PHC). Methods The outpatient data from 158 PHC institutions in Yinchuan from May 1, 2017 to April 30, 2020 were used. The difference in difference (DID) model was used to analyze the difference in the number of outpatient visits per day, total outpatient expenditure per day, and outpatient expenditure per visit between December 2019 and February 2020 compared with the same periods in two previous years. The autoregressive integrated moving average (ARIMA) modelling was used to investigate the association between the outpatient volume and the number of the last week’s new COVID-19 cases in Yinchuan, Ningxia, and China. Results From December 2019 to February 2020, the decline in the number of outpatient visits per day (DID: -367.21 times, P = .004) was larger than that in two previous years, and a similar trend can be seen in the outpatient expenditure per day. However, the rise in the outpatient expenditure per visit (DID: 19.06 thousand yuan, P = .003) was larger than that in two previous years. In 2020, the outpatient visits for most types of diseases decreased from week 3 and rebounded after week 5. The decline and rebound of outpatient visits in the population aged 45 years and older were steeper than in those younger. The outpatient volume was negatively associated with the number of the last week’s new COVID-19 cases. Conclusion This study indicated a significant impact of the pandemic on PHC service utilization. Since PHC service is the foundation of the healthcare system in most developing countries, measures should be taken to make PHC help cope with the crisis and relieve the burden of hospital care.

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