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.
Highlights
As health systems across the world respond to the coronavirus disease 2019 (COVID-19), there is rising concern that patients with non-COVID-19 emergency conditions are avoiding care.[1,2,3,4] In the Italian Paediatric Hospital Research Network, 12 cases of delayed access to hospital care were reported in 1 week, with 6 cases requiring admission to an intensive care unit and 4 deaths.[1]
More highly educated female respondents who reported a greater impact of COVID-19 on their mental health were associated with avoiding medical care from this public survey in Hong Kong
We found statistically significant associations between reported reductions in healthcare utilization and married, more highly educated women who seemed to fear COVID-19 more, further research is needed to identify in more detail why these associations exist and what elements of these associations or their interactions led to less healthcare utilization in during COVID-19
Summary
As health systems across the world respond to the coronavirus disease 2019 (COVID-19), there is rising concern that patients with non-COVID-19 emergency conditions are avoiding care.[1,2,3,4] In the Italian Paediatric Hospital Research Network, 12 cases of delayed access to hospital care were reported in 1 week, with 6 cases requiring admission to an intensive care unit and 4 deaths.[1]. In England, there is a rising concern that nonCOVID-19 patients are not receiving timely emergency care, which may be leading to preventable deaths.[5] The National Health Service (NHS) England reported a 29% fall in emergency department (ED) attendance and a 23% drop in emergency admissions in March 2020 compared to 2019, but a rise in registered non-COVID deaths. It is still unknown whether the drop in health service utilisation has impacted those who had time-critical medical emergencies and truly needed emergency care. The situation in the UK has exposed the difficulties of constructing a comprehensive and consistent picture of the wider effect of COVID-19 and the measures associated with controlling this pandemic
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: International Journal of Health Policy and Management
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
