• Am J Manag Care · Sep 2021

    Impact of COVID-19 pandemic on accessibility of Taiwanese medical care.

    • Yachung Jeng, Feng-Hsi Chen, Grace Hsiao-Hsuan Jen, Hsuan-Chih Chen, Amy Ming-Fang Yen, Chih-Dao Chen, Hsiu-Wen Kuo, Sen-Te Wang, and Chen-Yang Hsu.
    • Daichung Hospital, No. 304, Guangfu Rd, Zhunan Township, Miaoli, Taiwan. Email: bacilli65@gmail.com.
    • Am J Manag Care. 2021 Sep 1; 27 (9): e330-e335.

    ObjectivesWhether and how the COVID-19 pandemic affected utilization of routine medical care in areas with low infection risk, such as Taiwan, has not been widely addressed. We aimed to evaluate the impact of the COVID-19 pandemic on access to medical care.Study DesignBefore and after exposure (COVID-19 pandemic) design with a historical control group for comparison of clinical visits based on a retrospective cohort of 6722 customary patients of a community hospital in Zhunan, Taiwan.MethodsRepeated measurements of medical utilization in 4-month periods (January to April) of 2019 and 2020 in light of the emerging COVID-19 pandemic were collected. Access to medical care was defined as the mean frequencies of clinical visits. The impacts of the COVID-19 pandemic on access in the overall and specific groups were quantified with a multivariable Poisson regression model.ResultsThe overall outpatient visits per month declined by 39% (rate ratio [RR], 0.61; P < .0001) after adjusting for demographics. A notable reduction in visits was observed in foreign patients (RR, 0.50; P < .0001). The visits of the elderly (≥ 80 years) were the most frequent before the COVID-19 pandemic but were reduced by 44% (RR, 0.56; P < .0001) after it began. Most disease categories revealed a declining trend, but the size of reduction varied by International Classification of Diseases codes.ConclusionsThe COVID-19 pandemic prevented some individuals from keeping regular medical appointments even in an area with a low infection risk. Our findings imply that more research is required to mitigate the effects of delayed medical care for patients who infrequently utilized medical care during and after the long-lasting pandemic period.

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