Academic Journal

Impact of COVID-19 pandemic on utilisation of healthcare services: a systematic review

التفاصيل البيبلوغرافية
العنوان: Impact of COVID-19 pandemic on utilisation of healthcare services: a systematic review
المؤلفون: Mark Jones, Ray Moynihan, Minna Johansson, Ian Scott, Loai Albarqouni, Eddy Lang, Justin Clark, Zoe A Michaleff, Anne Duggan, Melissa Fox, Sharon Sanders, Anna Mae Scott, Emma J To, Eliza Kitchener
المصدر: BMJ Open, Vol 11, Iss 3 (2021)
بيانات النشر: BMJ Publishing Group, 2021.
سنة النشر: 2021
المجموعة: LCC:Medicine
مصطلحات موضوعية: Medicine
الوصف: Objectives To determine the extent and nature of changes in utilisation of healthcare services during COVID-19 pandemic.Design Systematic review.Eligibility Eligible studies compared utilisation of services during COVID-19 pandemic to at least one comparable period in prior years. Services included visits, admissions, diagnostics and therapeutics. Studies were excluded if from single centres or studied only patients with COVID-19.Data sources PubMed, Embase, Cochrane COVID-19 Study Register and preprints were searched, without language restrictions, until 10 August, using detailed searches with key concepts including COVID-19, health services and impact.Data analysis Risk of bias was assessed by adapting the Risk of Bias in Non-randomised Studies of Interventions tool, and a Cochrane Effective Practice and Organization of Care tool. Results were analysed using descriptive statistics, graphical figures and narrative synthesis.Outcome measures Primary outcome was change in service utilisation between prepandemic and pandemic periods. Secondary outcome was the change in proportions of users of healthcare services with milder or more severe illness (eg, triage scores).Results 3097 unique references were identified, and 81 studies across 20 countries included, reporting on >11 million services prepandemic and 6.9 million during pandemic. For the primary outcome, there were 143 estimates of changes, with a median 37% reduction in services overall (IQR −51% to −20%), comprising median reductions for visits of 42% (−53% to −32%), admissions 28% (−40% to −17%), diagnostics 31% (−53% to −24%) and for therapeutics 30% (−57% to −19%). Among 35 studies reporting secondary outcomes, there were 60 estimates, with 27 (45%) reporting larger reductions in utilisation among people with a milder spectrum of illness, and 33 (55%) reporting no difference.Conclusions Healthcare utilisation decreased by about a third during the pandemic, with considerable variation, and with greater reductions among people with less severe illness. While addressing unmet need remains a priority, studies of health impacts of reductions may help health systems reduce unnecessary care in the postpandemic recovery.PROSPERO registration number CRD42020203729.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 2044-6055
Relation: https://bmjopen.bmj.com/content/11/3/e045343.full; https://doaj.org/toc/2044-6055
DOI: 10.1136/bmjopen-2020-045343
URL الوصول: https://doaj.org/article/23b9f3c51cfd4f189e80cbe3ee04f399
رقم الانضمام: edsdoj.23b9f3c51cfd4f189e80cbe3ee04f399
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:20446055
DOI:10.1136/bmjopen-2020-045343