Health Service Utilization in Hong Kong During the COVID-۱۹ Pandemic – A Cross-sectional Public Survey

BackgroundAs health systems across the world respond to the coronavirus disease ۲۰۱۹ (COVID-۱۹), there is rising concern that patients without COVID-۱۹ are not receiving timely emergency care, resulting in avoidable deaths. This study examined patterns of self-reported health service utilization, their socio-demographic determinants and association with avoidable deaths during the COVID-۱۹ outbreak. MethodsA cross-sectional telephone survey was conducted between March ۲۲ and April ۱, ۲۰۲۰, during the peak rise in confirmed COVID-۱۹ cases in Hong Kong. Cantonese-speaking Hong Kong residents over ۱۸-years-old were recruited using a computerised random digital dialling (RDD) system. The RDD method used stratified random sampling to ensure a representative sample of the target population by age, gender, and residential district. A structured self-reported questionnaire was used. ResultsOut of ۱۷۳۸ placed calls, ۷۶۵ subjects responded to the questionnaire (۴۴.۰% response rate). The factors associated with avoiding medical consultation included being female (۳۷.۲% vs. ۲۲.۵%, P < .۰۰۱), married (۳۲.۸% vs. ۲۷%, P = .۰۴۴), completing tertiary education (۳۵.۳% vs. ۲۷.۷% (secondary) vs. ۱۴.۸% (primary), P = .۰۰۵), and those who reported a “large/very large” impact of COVID-۱۹ on their mental health (۳۶.۱% vs ۳۰.۵% (neutral) vs. ۱۹.۷% (very small/small), P = .۰۴۷) using logistic regression analysis. ConclusionMarried females with both higher educational attainment and concern about COVID-۱۹ were associated with avoiding healthcare services. Timely public communication to encourage and promote early health seeking treatment even during extreme events such as pandemics are needed.

Keywords:

Access to Healthcare , Health Seeking Behavior , Fear of Infection