Impact of coronavirus disease 2019 (COVID-19) pandemic on healthcare service utilization among elderly patients at Sunpasitthipasong Hospital
Article Sidebar
Main Article Content
Abstract
The elderly are a group that experiences high rates of illness and therefore require regular healthcare services. However, when there was an outbreak of COVID-19 in Thailand, it can impact on their ability to access healthcare services and clinical outcomes. Objectives: To analyze the rate of healthcare service utilization and clinical outcomes of the elderly during the COVID-19 pandemic compared to before the outbreak. Methodology: We conducted interrupted time series (ITS) analyses, calculating the Incidence Rate Ratio (IRR) and a 95% confidence interval. Using healthcare service utilization data from patients aged 60 and above who accessed outpatient and inpatient services from January 19, 2015 to December 31, 2021 at Sunpasitthiprasong hospital, Ubon Ratchathani. The data were obtained from an electronic medical record database. Results: All 137,525 patient’s data were collected. The COVID-19 pandemic had an impact on the number of patients and the number of visits of elderly patients who accessed out-patient services, but there was no statistically significant difference compared to the pre-pandemic period (IRR 1.03; 95% CI 0.99-1.08 and IRR 0.99; 95% CI 0.94-1.05, respectively). Moreover, there was a statistically significant difference in the number of patients and the number of visits of elderly patients who received inpatient services during the pandemic period compared to the pre-pandemic period (IRR 1.13; 95% CI 1.07-1.19 and IRR 1.13; 95% CI 1.07-1.19, respectively). Regarding clinical outcomes, the in-hospital mortality rate among elderly patients significantly increased during the outbreak compared to the pre-outbreak period, particularly among those aged 60–64 years and patients under the Universal Health Coverage scheme. Overall, the 30-day hospital readmission rate remained unchanged. However, subgroup analysis revealed a statistically significant increase in readmission rates among patients covered by the Social Security Scheme and other healthcare benefit programs. Conclusion: The COVID-19 pandemic led to a significant increase in hospital admissions among the elderly, along with higher in-hospital mortality rates, particularly among those aged 60–64 years and patients under the Universal Health Coverage scheme.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
In the case that some parts are used by others The author must Confirm that obtaining permission to use some of the original authors. And must attach evidence That the permission has been included
References
Ahn S, Kim S, Koh K. Associations of the COVID-19 pandemic with older individuals’ healthcare utilization and self-reported health status: a longitudinal analysis from Singapore. BMC Health Serv Res. 2022;22(1):66. doi:10.1186/s12913-021-07446-5
Ayele TA, Alamneh TS, Shibru H, Sisay MM, Yilma TM, Melak MF, et al. Effect of COVID-19 pandemic on missed medical appointment among adults with chronic disease conditions in Northwest Ethiopia. PLoS One. 2022;17(10):e0274190. doi:10.1371/journal.pone.0274190
Bitew Workie S, Mekonen N, Michael MW, Molla G, Abrha S, Zema Z, et al. Modern Health Service Utilization and Associated Factors among Adults in Southern Ethiopia. J Environ Public Health. 2021;2021:8835780. doi:10.1155/2021/8835780
Tai CH, Kao YH, Lai YW, Chen JH, Chen WL, Chung JY. Impact of the COVID-19 pandemic on medical-seeking behavior in older adults by comparing the presenting complaints of the emergency department visits. BMC Emerg Med. 2023;23(1):63. doi:10.1186/s12873-023-00819-5
Cosentino N, Assanelli E, Merlino L, Mazza M, Bartorelli AL, Marenzi G. An In-hospital Pathway for Acute Coronary Syndrome Patients During the COVID-19 Outbreak: Initial Experience Under Real-World Suboptimal Conditions. Can J Cardiol. 2020;36(6):961-4. doi:10.1016/j.cjca.2020.04.011
Djaharuddin I, Munawwarah S, Nurulita A, Ilyas M, Tabri NA, Lihawa N. Comorbidities and mortality in COVID-19 patients. Gac Sanit. 2021;35 Suppl 2:S530-S2. doi:10.1016/j.gaceta.2021.10.085
Donsamak S, Leelahavarong P, Ponragdee K, Angkab P, Hadnorntun P, Prawjaeng J, et al. Telemedicine for elderly outpatient care during COVID-19 pandemic: qualitative study. IJPS. 2024;20(1):15.
Faraji-Khiavi F, Jalilian H, Heydari S, Sadeghi R, Saduqi M, Razavinasab SA, et al. Utilization of health services among the elderly in Iran during the COVID-19 outbreak: A cross-sectional study. Health Sci Rep. 2022;5(5):e839. doi:10.1002/hsr2.839
Gerst-Emerson K, Jayawardhana J. Loneliness as a public health issue: the impact of loneliness on health care utilization among older adults. Am J Public Health. 2015;105(5):1013-9. doi:10.2105/ajph.2014.302427
Hu R, Zou H, Shen C, Heng F. Health care system reform in China: issues, challenges and options. Beijing: China Economics and Management Academy, Central University of Finance and Economics; 2011.
Khemapech I, Sansrimahachai W, Toachoodee M. Telemedicine–meaning, challenges and opportunities. Siriraj Med J. 2019;71(3):246-52.
Lian J, Jin X, Hao S, Cai H, Zhang S, Zheng L, et al. Analysis of Epidemiological and Clinical Features in Older Patients With Coronavirus Disease 2019 (COVID-19) Outside Wuhan. Clin Infect Dis. 2020;71(15):740-7. doi:10.1093/cid/ciaa242
Michalowsky B, Hoffmann W, Bohlken J, Kostev K. Effect of the COVID-19 lockdown on disease recognition and utilisation of healthcare services in the older population in Germany: a cross-sectional study. Age Ageing. 2020;50(2):317-25. doi:10.1093/ageing/afaa260
Moynihan R, Sanders S, Michaleff ZA, Scott AM, Clark J, To EJ, et al. Impact of COVID-19 pandemic on utilisation of healthcare services: a systematic review. BMJ Open. 2021;11(3):e045343. doi:10.1136/bmjopen-2020-045343
National Statistical Office, Thailand. Number of population from registration by age, sex, region and province: 2023 [Internet]. 2023 [cited 2025 Apr 17]. Available from: https://www.nso.go.th/nsoweb/nso/statistics_and_indicators?impt_branch=300
Park K, Byeon J, Yang Y, Cho H. Healthcare utilisation for elderly people at the onset of the COVID-19 pandemic in South Korea. BMC Geriatr. 2022;22(1):395. doi:10.1186/s12877-022-03085-5
Singh DR, Sunuwar DR, Shah SK, Karki K, Sah LK, Adhikari B, et al. Impact of COVID-19 on health services utilization in Province-2 of Nepal: a qualitative study among community members and stakeholders. BMC Health Serv Res. 2021;21(1):174. doi:10.1186/s12913-021-06176-y
Vigezzi GP, Bertuccio P, Amerio A, Bosetti C, Gori D, Cavalieri d'Oro L, et al. Older Adults' Access to Care during the COVID-19 Pandemic: Results from the LOckdown and LifeSTyles (LOST) in Lombardia Project. Int J Environ Res Public Health. 2022;19(18):11271. doi:10.3390/ijerph191811271
