Kang Taeuk, Lee Yoonkyoung, Kang Minku
Health and Wellness College, Sungshin Women's University Woonjung Green Campus, Seoul, Republic of Korea.
BK21 Center for Integrative Responses to Health Disasters, Seoul National University Graduate School of Public Health, Gwanak-ro, Gwanak-gu, Seoul, Republic of Korea.
Prev Med Rep. 2024 Mar 13;41:102680. doi: 10.1016/j.pmedr.2024.102680. eCollection 2024 May.
From 2020 to 2022, South Korea has experienced significant direct and indirect damage because of the coronavirus pandemic. Preventive measures aimed at controlling the spread of the virus have inadvertently limited healthcare accessibility for patients without COVID-19, leading to detrimental consequences, particularly for patients with chronic diseases. Hence, there is a growing need to comprehensively examine the changes in healthcare utilization among patients with chronic diseases owing to the COVID-19 pandemic, along with the associated factors and health outcomes.
To examine changes in healthcare utilization among patients with chronic diseases and their impact on health outcomes, we used the NHIS database. Logistic regression analysis was used to investigate changes in healthcare utilization, and a two-part model was applied to explore the effects of reduced healthcare utilization on hospitalization status and length of hospital stay.
Since the onset of the pandemic, the likelihood of hospitalization has been 1.10 times higher than that during pre-pandemic times in the population groups with a 20 % decrease in outpatient healthcare utilization. Notably, individuals belonging to the low-income group exhibited a 1.77-fold higher likelihood of hospitalization than those in the high-income group. Furthermore, in cases where hospitalization could have been avoided, low-income individuals had an extended hospital stay of 16.7 days compared with high-income individuals.
There is a need for a more proactive approach for classifying patients with chronic diseases based on various vulnerability factors to effectively respond to future novel infectious diseases and reduce the long-term burden on the nation.
2020年至2022年期间,韩国因新冠疫情遭受了重大的直接和间接损害。旨在控制病毒传播的预防措施无意中限制了非新冠患者获得医疗服务的机会,导致了有害后果,尤其是对慢性病患者。因此,越来越有必要全面审视新冠疫情对慢性病患者医疗服务利用情况的影响,以及相关因素和健康结果。
为了研究慢性病患者医疗服务利用情况的变化及其对健康结果的影响,我们使用了韩国国民健康保险服务(NHIS)数据库。采用逻辑回归分析来研究医疗服务利用情况的变化,并应用两部分模型来探讨医疗服务利用减少对住院状态和住院时间的影响。
自疫情爆发以来,门诊医疗服务利用率下降20%的人群住院可能性比疫情前高出1.10倍。值得注意的是,低收入群体住院的可能性比高收入群体高出1.77倍。此外,在本可避免住院的情况下,低收入个体比高收入个体的住院时间延长了16.7天。
有必要采取更积极主动的方法,根据各种脆弱因素对慢性病患者进行分类,以有效应对未来的新型传染病,并减轻国家的长期负担。