Impact of the COVID-۱۹ Pandemic on Outpatient Service in Primary Healthcare Institutions: An Inspiration From Yinchuan of China

Background  The coronavirus disease ۲۰۱۹ (COVID-۱۹) pandemic has posed a great challenge to the healthcare system. This study evaluated the impact of the pandemic on the utilization of primary healthcare (PHC). Methods  The outpatient data from ۱۵۸ PHC institutions in Yinchuan from May ۱, ۲۰۱۷ to April ۳۰, ۲۰۲۰ were used. The difference in difference (DID) model was used to analyze the difference in the number of outpatient visits per day, total outpatient expenditure per day, and outpatient expenditure per visit between December ۲۰۱۹ and February ۲۰۲۰ compared with the same periods in two previous years. The autoregressive integrated moving average (ARIMA) modelling was used to investigate the association between the outpatient volume and the number of the last week’s new COVID-۱۹ cases in Yinchuan, Ningxia, and China. Results  From December ۲۰۱۹ to February ۲۰۲۰, the decline in the number of outpatient visits per day (DID: -۳۶۷.۲۱ times, P = .۰۰۴) was larger than that in two previous years, and a similar trend can be seen in the outpatient expenditure per day. However, the rise in the outpatient expenditure per visit (DID: ۱۹.۰۶ thousand yuan, P = .۰۰۳) was larger than that in two previous years. In ۲۰۲۰, the outpatient visits for most types of diseases decreased from week ۳ and rebounded after week ۵. The decline and rebound of outpatient visits in the population aged ۴۵ years and older were steeper than in those younger. The outpatient volume was negatively associated with the number of the last week’s new COVID-۱۹ cases. Conclusion This study indicated a significant impact of the pandemic on PHC service utilization. Since PHC service is the foundation of the healthcare system in most developing countries, measures should be taken to make PHC help cope with the crisis and relieve the burden of hospital care.

Keywords:

COVID-۱۹ , Outpatients , Primary Healthcare , Utilization , Temporal Trend