两段时期的故事：伊朗在 COVID-19 之前和期间的医疗保健利用模式探索。

A tale of two times: an exploration of healthcare utilization patterns before and during COVID-19 in Iran.

机构信息

Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Faculty of Health, Education and Life Sciences, School of Nursing and Midwifery, Birmingham City University, Birmingham, UK.

出版信息

BMC Public Health. 2024 Oct 25;24(1):2961. doi: 10.1186/s12889-024-20452-6.

DOI:10.1186/s12889-024-20452-6

PMID:39455941

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11515307/

Abstract

BACKGROUND

The COVID-19 pandemic has impacted global healthcare utilization patterns. This study aimed to examine the impact of COVID-19 pandemic on utilization rate of healthcare services in Iran.

METHOD

In this quasi-experimental study, data on the utilization rates of laboratory services, sonography exams, CT scans, MRIs, and EKGs was collected from the Social Security Organization (SSO)'s insurance information system. This data, covering 47 months prior to the pandemic and 25 months during it, was analyzed to assess the pandemic's impact on healthcare utilization among insured individuals in Iran. The data was categorized into direct, indirect, and total sectors, and an Interrupted Time Series Analysis (ITSA) model was employed for data analysis, examining both total and sector-specific utilization rates.

FINDINGS

The study for single group indicated that in the total sector, Utilization rate per 1000 insured significantly decreased by 25.25 for laboratory services, decreased by 3.99 for sonography, decreased by 1.08 for MRIs and decreased by 1.01 for EKGs, but increased by 2.28 for CT scans in the first pandemic month. Over following months, monthly utilization trends per 1000 insured increased significantly- laboratory services + 1.08, sonography + 0.11, CT scans + 0.12, MRIs + 0.06, and EKGs + 0.05. Pre-pandemic, monthly utilization per 1000 insured was 62.68 labs, 14.47 sonography, 0.72 CT scans, 2.06 MRIs, with all significantly higher in the indirect over direct sector except EKGs which were 2.08 higher in the direct sector. In the first pandemic month, there were significant between-sector differences per 1000 of -4.4 for sonography, + 1.89 CT scans, -1.01 MRIs and + 1.29 EKGs.

CONCLUSION

The COVID-19 pandemic led to a significant decline in healthcare service utilization, particularly in total and direct sectors, while CT scans remained unaffected. To address these challenges and meet patient needs, Iran's health system should adopt alternative delivery methods like telemedicine.

摘要

背景

COVID-19 大流行对全球医疗保健利用模式产生了影响。本研究旨在探讨 COVID-19 大流行对伊朗医疗服务利用率的影响。

方法

在这项准实验研究中，从社会安全组织（SSO）的保险信息系统中收集了实验室服务、超声检查、CT 扫描、MRI 和心电图（EKG）利用率的数据。该数据涵盖了大流行前的 47 个月和大流行期间的 25 个月，用于评估大流行对伊朗参保人员医疗保健利用的影响。数据分为直接、间接和总部门，采用中断时间序列分析（ITSA）模型进行数据分析，同时分析总部门和具体部门的利用率。

结果

单组研究表明，在总部门，实验室服务的每千名参保人员利用率显著下降 25.25%，超声检查下降 3.99%，MRI 下降 1.08%，EKG 下降 1.01%，但在第一个大流行月 CT 扫描增加 2.28%。在随后的几个月中，每千名参保人员的每月利用趋势显著增加-实验室服务增加 1.08%，超声检查增加 0.11%，CT 扫描增加 0.12%，MRI 增加 0.06%，EKG 增加 0.05%。在大流行前，每千名参保人员的每月利用量为 62.68 个实验室、14.47 个超声检查、0.72 个 CT 扫描、2.06 个 MRI，除 EKG 外，所有这些指标在间接部门均显著高于直接部门，而 EKG 则在直接部门高 2.08%。在第一个大流行月，每千名参保人员在超声检查、CT 扫描、MRI 和 EKG 方面的部门间差异分别为-4.4、+1.89、-1.01 和+1.29。