Escuela de Medicina Humana, Universidad César Vallejo, Trujillo, Peru.
Instituto Peruano de Orientación Psicológica, Lima, Peru.
JMIR Ment Health. 2024 Jul 8;11:e53980. doi: 10.2196/53980.
The COVID-19 pandemic led to a global reduction in health care accessibility for both infected and noninfected patients, posing a particular burden on those with chronic conditions, including mental health issues. Peru experienced significant devastation from the pandemic, resulting in a collapsed health care system and leading to the world's highest per capita mortality rate as a result of COVID-19. Understanding the trends in health care utilization, particularly in mental health care, is crucial for informing pandemic response efforts and guiding future recovery strategies.
This study aims to analyze the trends of outpatient medical and psychiatric consultations during the COVID-19 pandemic in a national hospital in Peru.
This observational study was conducted at a national hospital in Lima, Peru. We analyzed data on user care across all services, including psychiatric services, from May 2019 to December 2022. The data were calculated for users served per month, including the number of users seen monthly in mental health services. Sociodemographic variables such as sex (female or male), age (≥0 years), type of medical appointment (regular or additional), and modality of care (in-person or teleconsultations) were taken into account. An interrupted time series regression model was conducted to assess the number of outpatient medical and psychiatric consultations. Subgroup analyses were performed based on service modality, including overall consultations, telemonitoring/teleconsultations only, or face-to-face only, for all service users and for mental health service users.
A total of 1,515,439 participants were included, with females comprising 275,444/484,994 (56.80%) of the samples. Only 345,605/1,515,439 (22.81%) visits involved telemedicine. The total monthly outpatient visits were significantly reduced compared with the expected projection (P<.001) at the beginning of the pandemic, followed by a later monthly increment of 298.7 users. Face-to-face interventions experienced a significant reduction at the beginning of the pandemic (P<.001), gradually recovering in the following months. By contrast, telemedicine use initially increased but subsequently declined toward the end of the pandemic. A similar trend was observed in mental health units.
During the pandemic years, health care utilization in both general and psychiatric services experienced a significant decrease, particularly at the beginning of the pandemic (March 2020). However, no significant trends were observed in either case throughout the pandemic period. Telemedicine consultations witnessed a significant increase overall during this period, particularly among mental health users.
COVID-19 大流行导致全球感染和未感染患者的医疗可及性降低，这对包括精神健康问题在内的慢性病患者造成了特别的负担。秘鲁在大流行中遭受了巨大破坏，导致医疗保健系统崩溃，并导致 COVID-19 导致的人均死亡率成为世界最高。了解医疗保健利用趋势，特别是精神保健，对于为大流行应对工作提供信息和指导未来的恢复策略至关重要。
本研究旨在分析秘鲁一家国家医院在 COVID-19 大流行期间的门诊医疗和精神病咨询趋势。
本观察性研究在秘鲁利马的一家国家医院进行。我们分析了 2019 年 5 月至 2022 年 12 月期间所有服务（包括精神科服务）的用户护理数据。数据按月计算，包括每月在精神卫生服务中就诊的用户数量。考虑了社会人口统计学变量，如性别（女性或男性）、年龄（≥0 岁）、医疗预约类型（常规或额外）和护理方式（门诊或远程咨询）。进行了中断时间序列回归模型分析以评估门诊医疗和精神病咨询次数。根据服务方式进行了亚组分析，包括所有服务用户的总体咨询、仅远程监测/远程咨询或仅面对面咨询，以及精神卫生服务用户。
共纳入 1515439 名参与者，其中女性占 275444/484994（56.80%）。只有 345605/1515439（22.81%）就诊涉及远程医疗。与大流行前的预期预测相比，大流行开始时门诊就诊总次数明显减少（P<.001），随后每月增加 298.7 人。面对面干预在大流行开始时显著减少（P<.001），随后在接下来的几个月中逐渐恢复。相比之下，远程医疗的使用最初增加，但在大流行结束时逐渐下降。在精神卫生单位也观察到类似的趋势。
在大流行期间，普通和精神科服务的医疗保健利用率均显著下降，尤其是在大流行开始时（2020 年 3 月）。然而，在整个大流行期间，这两种情况都没有观察到明显的趋势。在此期间，远程医疗咨询总体上显著增加，特别是在精神卫生用户中。
