Document Type : Original Article
Authors
1
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
2
Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
3
Maternal and Child Health Care Hospital of Ningxia Hui Autonomous Region, Yinchuan, China
4
Peking University Health Information Technology Co. Ltd, Beijing, China
5
Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing, China
6
Department of Paediatrics, Peking University First Hospital, Beijing, China
Abstract
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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