Amid COVID-19 pandemic, are non-COVID patients left in the lurch?

Laima Alam,Mafaza Alam,Syed Kumail Hasan Kazmi,Varqa Faraid

doi:10.12669/pjms.37.2.3536

Abstract

Objectives:1) To explore the possible impact of the pandemic on the health seeking behavior of the patients, 2) To explore the relation of socio-demographics on the utility of health-care facilities.Methods:This cross-sectional study was conducted by enrolling all patients ≥15 years of age presenting to the Out-Patient-Department of three main public-hospitals after obtaining ethical committee approval. A questionnaire with validated Urdu translation was filled by each participant that included socio-demographic data, pre-Covid and Covid-19 era health seeking behaviors and the impact of the pandemic on the utilization of healthcare facilities. Data was analyzed using SPSS V.19.Results:A total of 393 patients were enrolled with a male preponderance (72%) and a median age range of 31-45 years. Fifty-eight percent of the study population was unemployed and 47.3% were seeking follow up care. The frequency of ER and multiple (>4 times) OPD visits were significantly decreased in the Covid-19 times whereas, the laboratory and radiology services were largely unaffected. A significant number of patients were not satisfied with the current healthcare facilities that was seen irrespective of the socio-demographic status. Emergency Room and radiology services were largely unaffected whereas, elective procedures and laboratory facilities were reported to be severely affected or delayed in relation to socio-demographic variables.Conclusions:Healthcare inequalities have widened and depression has shown a sharp rise during this pandemic. The over-burdened healthcare facilities at the verge of collapse may miss out on the chronic non-Covid patients which would ultimately lead to increased morbidity and mortality.

Highlights

Due to the unprecedented conditions secondary to Covid-19 pandemic, the hospitals and emergency departments are overwhelmed with critically ill patients
The frequency of multiple (>4 times) OPD visits was significantly decreased in the Covid times either due to non-availability of services for follow up of chronic illnesses or deliberate avoidance whereas, the laboratory and radiology services were largely unaffected (Table-II)
Radiology services were reported to be prompt with no major delays

Summary

Introduction

Due to the unprecedented conditions secondary to Covid-19 pandemic, the hospitals and emergency departments are overwhelmed with critically ill patients. The already fragile health care system of many developing as well as the developed countries has collapsed, making preventive techniques and effective infection control the major facets of clinical care.[1] The importance of hospital readiness and establishment of fool proof triage systems for patient segregation and staff safety has been tremendously emphasized.[2]. An analysis from the United States showed a 40% reduction in STEMI presentation in Rhodes Island and a similar study reported a 50% reduction in emergency department visits (other than respiratory symptoms).[3] This has led to the speculation that many patients with worrisome and serious symptoms might be avoiding the hospitals, causing delayed diagnosis and increased morbidity and mortality.[4]

Objectives

Methods

Results