Long-term impact of the COVID-19 pandemic on health services utilization in China: A nationwide longitudinal study
Background: Long-term impact of the COVID-19 pandemic on health services utilization is unknown. We aim to assess the long-term effect of the COVID-19 pandemic on health services utilization in China. Methods: Between Jan 2017 and Dec 2021, we conducted a nationwide longitudinal study using routinel...
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| Format: | Article |
| Language: | English |
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KeAi Communications Co., Ltd.
2023-01-01
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| Series: | Global Transitions |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S258979182300004X |
| _version_ | 1797391797549268992 |
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| author | Jue Liu Xiaohui Zhai Wenxin Yan Qiao Liu Min Liu Wannian Liang |
| author_facet | Jue Liu Xiaohui Zhai Wenxin Yan Qiao Liu Min Liu Wannian Liang |
| author_sort | Jue Liu |
| collection | DOAJ |
| description | Background: Long-term impact of the COVID-19 pandemic on health services utilization is unknown. We aim to assess the long-term effect of the COVID-19 pandemic on health services utilization in China. Methods: Between Jan 2017 and Dec 2021, we conducted a nationwide longitudinal study using routinely collected data on health services utilization in the National Health Information System of China. We extracted national and provincial data of demographic characteristics, socio-economic characteristics, and health resources. Interrupted time-series segmented negative binominal regression models were used. Results: A total of 34.2 billion health facilities visits and 1.1 billion inpatients discharged were included. The largest negative impact of COVID-19 pandemic on the health services utilization was during containment period, that health facility visits were observed 32% reduction in hospitals (adjusted incidence risk ratios [aRRs] 0.68, 95%CI: 0.50–0.92), 27% reduction in community health centers (aRR 0.73, 95%CI: 0.57–0.93), and 22% reduction township centers (aRR 0.78, 95%CI: 0.67–0.91), respectively. The impact on health facility visits and inpatients discharged were reduced and eliminated over time (all p>0.05). However, the negative impact on utilization rate of beds, average length of stay, average inpatient costs, and average outpatient costs in different level of health facilities still existed two years later (all p<0.05). Conclusions: The impact of the COVID-19 pandemic on health services utilization was largest during containment period and reduced over time, but it still existed two years later. There are disparities in the recovery of health services. Our findings highlighted the importance of maintaining primary healthcare services during the pandemic and strengthen resilient health system on the rapid recovery of medical services. |
| first_indexed | 2024-03-08T23:37:54Z |
| format | Article |
| id | doaj.art-8c90ca8988b648ceb3aff4464fb3edc5 |
| institution | Directory Open Access Journal |
| issn | 2589-7918 |
| language | English |
| last_indexed | 2024-03-08T23:37:54Z |
| publishDate | 2023-01-01 |
| publisher | KeAi Communications Co., Ltd. |
| record_format | Article |
| series | Global Transitions |
| spelling | doaj.art-8c90ca8988b648ceb3aff4464fb3edc52023-12-14T05:23:32ZengKeAi Communications Co., Ltd.Global Transitions2589-79182023-01-0152128Long-term impact of the COVID-19 pandemic on health services utilization in China: A nationwide longitudinal studyJue Liu0Xiaohui Zhai1Wenxin Yan2Qiao Liu3Min Liu4Wannian Liang5Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, China; Institute for Global Health and Development, Peking University, No. 5 Yiheyuan Road, Haidian, Beijing, 100871, ChinaMedical Management Center, National Health Commission of the People's Republic of China, No. 1, Xizhimenwai South Road, Xicheng District, Beijing, 100044, ChinaDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, ChinaDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, ChinaDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, China; Corresponding author. School of Public Health, Peking University. No. 38, Xueyuan Road, Haidian District, Beijing, 100191, China.Vanke School of Public Health, Tsinghua University, No. 30, Shuangqing Road, Haidian District, 100084, Beijing, China; Institute for Healthy China, Tsinghua University, No. 30, Shuangqing Road, Haidian District, 100084, Beijing, China; Corresponding author. Vanke School of Public Health, Tsinghua University, Beijing, 100084, China.Background: Long-term impact of the COVID-19 pandemic on health services utilization is unknown. We aim to assess the long-term effect of the COVID-19 pandemic on health services utilization in China. Methods: Between Jan 2017 and Dec 2021, we conducted a nationwide longitudinal study using routinely collected data on health services utilization in the National Health Information System of China. We extracted national and provincial data of demographic characteristics, socio-economic characteristics, and health resources. Interrupted time-series segmented negative binominal regression models were used. Results: A total of 34.2 billion health facilities visits and 1.1 billion inpatients discharged were included. The largest negative impact of COVID-19 pandemic on the health services utilization was during containment period, that health facility visits were observed 32% reduction in hospitals (adjusted incidence risk ratios [aRRs] 0.68, 95%CI: 0.50–0.92), 27% reduction in community health centers (aRR 0.73, 95%CI: 0.57–0.93), and 22% reduction township centers (aRR 0.78, 95%CI: 0.67–0.91), respectively. The impact on health facility visits and inpatients discharged were reduced and eliminated over time (all p>0.05). However, the negative impact on utilization rate of beds, average length of stay, average inpatient costs, and average outpatient costs in different level of health facilities still existed two years later (all p<0.05). Conclusions: The impact of the COVID-19 pandemic on health services utilization was largest during containment period and reduced over time, but it still existed two years later. There are disparities in the recovery of health services. Our findings highlighted the importance of maintaining primary healthcare services during the pandemic and strengthen resilient health system on the rapid recovery of medical services.http://www.sciencedirect.com/science/article/pii/S258979182300004X |
| spellingShingle | Jue Liu Xiaohui Zhai Wenxin Yan Qiao Liu Min Liu Wannian Liang Long-term impact of the COVID-19 pandemic on health services utilization in China: A nationwide longitudinal study Global Transitions |
| title | Long-term impact of the COVID-19 pandemic on health services utilization in China: A nationwide longitudinal study |
| title_full | Long-term impact of the COVID-19 pandemic on health services utilization in China: A nationwide longitudinal study |
| title_fullStr | Long-term impact of the COVID-19 pandemic on health services utilization in China: A nationwide longitudinal study |
| title_full_unstemmed | Long-term impact of the COVID-19 pandemic on health services utilization in China: A nationwide longitudinal study |
| title_short | Long-term impact of the COVID-19 pandemic on health services utilization in China: A nationwide longitudinal study |
| title_sort | long term impact of the covid 19 pandemic on health services utilization in china a nationwide longitudinal study |
| url | http://www.sciencedirect.com/science/article/pii/S258979182300004X |
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