Health Service Utilization in Hong Kong During the COVID-19 Pandemic – A Cross-sectional Public Survey

Document Type : Original Article

Authors

1 Accident & Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China

2 Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), The Chinese University of Hong Kong, Hong Kong, China

3 JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China

4 Nuffield Department of Medicine, University of Oxford, Oxford, UK

Abstract

Background
As health systems across the world respond to the coronavirus disease 2019 (COVID-19), there is rising concern that patients without COVID-19 are not receiving timely emergency care, resulting in avoidable deaths. This study examined patterns of self-reported health service utilization, their socio-demographic determinants and association with avoidable deaths during the COVID-19 outbreak.
 
Methods
A cross-sectional telephone survey was conducted between March 22 and April 1, 2020, during the peak rise in confirmed COVID-19 cases in Hong Kong. Cantonese-speaking Hong Kong residents over 18-years-old were recruited using a computerised random digital dialling (RDD) system. The RDD method used stratified random sampling to ensure a representative sample of the target population by age, gender, and residential district. A structured self-reported questionnaire was used.
 
Results
Out of 1738 placed calls, 765 subjects responded to the questionnaire (44.0% response rate). The factors associated with avoiding medical consultation included being female (37.2% vs. 22.5%, P < .001), married (32.8% vs. 27%, P = .044), completing tertiary education (35.3% vs. 27.7% (secondary) vs. 14.8% (primary), P = .005), and those who reported a “large/very large” impact of COVID-19 on their mental health (36.1% vs 30.5% (neutral) vs. 19.7% (very small/small), P = .047) using logistic regression analysis.
 
Conclusion
Married females with both higher educational attainment and concern about COVID-19 were associated with avoiding healthcare services. Timely public communication to encourage and promote early health seeking treatment even during extreme events such as pandemics are needed.

Keywords

Main Subjects

References

  1. Lazzerini M, Barbi E, Apicella A, Marchetti F, Cardinale F, Trobia G. Delayed access or provision of care in Italy resulting from fear of COVID-19. Lancet Child Adolesc Health. 2020;4(5):e10-e11. doi:10.1016/s2352-4642(20)30108-5
  2. Tam CF, Cheung KS, Lam S, et al. Impact of coronavirus disease 2019 (COVID-19) outbreak on ST-segment-elevation myocardial infarction care in Hong Kong, China. Circ Cardiovasc Qual Outcomes. 2020;13(4):e006631. doi:10.1161/circoutcomes.120.006631
  3. De Rosa S, Spaccarotella C, Basso C, et al. Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 era. Eur Heart J. 2020;41(22):2083-2088. doi:10.1093/eurheartj/ehaa409
  4. Garcia S, Albaghdadi MS, Meraj PM, et al. Reduction in ST-segment elevation cardiac catheterization laboratory activations in the United States during COVID-19 pandemic. J Am Coll Cardiol. 2020;75(22):2871-2872. doi:10.1016/j.jacc.2020.04.011
  5. Appleby J. What is happening to non-covid deaths? BMJ. 2020;369:m1607. doi:10.1136/bmj.m1607
  6. Hung KKC, Walline JH, Graham CA. COVID-19: emergency medicine perspectives from Hong Kong. Eur J Emerg Med. 2020;27(3):163-164. doi:10.1097/mej.0000000000000708
  7. Hospital Authority Clinical Data Analysis and Reporting System, Hospital Authority, Hong Kong SAR. Accessed May 7, 2020.
  8. LKS Faculty of Medicine, The University of Hong Kong. News: HKUMed Research Shows that Stroke Patients are Presenting to Hospitals One Hour Later During COVID-19, Potentially Jeopardising the Patients’ Eligibility for Treatments and Affecting the Outcome. HKUMed; 2020. https://www.med.hku.hk/en/News/stroke-patients-are-presenting-to-hospitals-one-hour-later-during-COVID-19.  Accessed May 27, 2020.
  9. Chan EYY, Huang Z, Lo ESK, Hung KKC, Wong ELY, Wong SYS. Sociodemographic predictors of health risk perception, attitude and behavior practices associated with health-emergency disaster risk management for biological hazards: the case of COVID-19 pandemic in Hong Kong, SAR China. Int J Environ Res Public Health. 2020;17(11). doi:10.3390/ijerph17113869
  10. Census and Statistics Department, Hong Kong Special Administrative Region. Thematic Household Survey Report No. 68. https://www.statistics.gov.hk/pub/B11302682019XXXXB0100.pdf.  Accessed May 11, 2020.
  11. Chang HJ, Huang N, Lee CH, Hsu YJ, Hsieh CJ, Chou YJ. The impact of the SARS epidemic on the utilization of medical services: SARS and the fear of SARS. Am J Public Health. 2004;94(4):562-564. doi:10.2105/ajph.94.4.562
  12. Chowell G, Abdirizak F, Lee S, et al. Transmission characteristics of MERS and SARS in the healthcare setting: a comparative study. BMC Med. 2015;13:210. doi:10.1186/s12916-015-0450-0
  13. Man CY, Yeung RS, Chung JY, Cameron PA. Impact of SARS on an emergency department in Hong Kong. Emerg Med (Fremantle). 2003;15(5-6):418-422. doi:10.1046/j.1442-2026.2003.00495.x
  14. Wolf MS, Serper M, Opsasnick L, et al. Awareness, attitudes, and actions related to COVID-19 among adults with chronic conditions at the onset of the US outbreak: a cross-sectional survey. Ann Intern Med. 2020;173(2):100-109. doi:10.7326/m20-1239
  15. World Health Organization (WHO). Rapid Assessment of Service Delivery for NCDs During COVID-19 Pandemic. Geneva: WHO; 2020.
  16. Hollander JE, Carr BG. Virtually perfect? Telemedicine for Covid-19. N Engl J Med. 2020;382(18):1679-1681. doi:10.1056/NEJMp2003539
  17. Auener S, Kroon D, Wackers E, Dulmen SV, Jeurissen P. COVID-19: a window of opportunity for positive healthcare reforms. Int J Health Policy Manag. 2020;9(10):419-422. doi:10.34172/ijhpm.2020.66
  18. Office of the Communications Authority. Key Communications Statistics. Hong Kong Special Administrative Region. https://www.ofca.gov.hk/en/data_statistics/data_statistics/key_stat/.  Accessed May 27, 2020.
  19. Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region. Latest situation of cases of COVID-19 (as of May 24, 2020). https://www.chp.gov.hk/files/pdf/local_situation_covid19_en.pdf.  Accessed May 25, 2020.
International Journal of Health Policy and Management
Volume 11, Issue 4
April 2022
Pages 508-513

Files

History

  • Receive Date: 28 May 2020
  • Revise Date: 18 September 2020
  • Accept Date: 20 September 2020
  • First Publish Date: 19 October 2020

Share

How to cite

Statistics