Pandemic and hospital avoidance: Evidence from the 2015 Middle East respiratory syndrome outbreak in South Korea

Abstract

Existing literature shows that people exhibit disease avoidance behaviors in response to contagious disease outbreaks. We examine hospital avoidance behaviors during the 2015 Middle East respiratory syndrome (MERS) outbreak in South Korea. The outbreak provides an excellent setting for the analysis because unlike the coronavirus disease-19 (COVID-19) situation, no mandatory lockdown was imposed during the outbreak, and the economic impact was also not large. Hence, reduced hospital visits are likely to reflect the public’s intention to avoid hospitals to protect themselves from getting infected with MERS. Moreover, the outbreak did not spread to the entire country and vanished after a short period of time, allowing us to consider the affected regions as the treatment group and the other regions as the control group without much concern of confounding by other factors. The data come from a government agency, which assesses (national) health insurance claims made by hospitals, and hence cover all outpatient visits in the country. We find that people reduced outpatient visits by about 17% in response to the MERS outbreak, and the response was the most intense when new cases were reported most frequently.