Pattern of OPD utilisation during the COVID-19 pandemic under the Universal Coverage Scheme in Thailand: what can 850 million records tell us?

BMC Health Services Research

Research

Rukmanee Butchon¹  Jarawee Sukmanee¹  Thanayut Saeraneesopon¹  Chulathip Boonma¹  Picharee Karunayawong¹  Wanrudee Isaranuwatchai²  Yot Teerawattananon³ 

[1] Department of Health Ministry of Public Health, Health Intervention and Technology Assessment Program (HITAP), 6Th Floor, 6Th Building, Nonthaburi, Thailand;Department of Health Ministry of Public Health, Health Intervention and Technology Assessment Program (HITAP), 6Th Floor, 6Th Building, Nonthaburi, Thailand;Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada;Department of Health Ministry of Public Health, Health Intervention and Technology Assessment Program (HITAP), 6Th Floor, 6Th Building, Nonthaburi, Thailand;Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore;Health Administration Division, Office of the Permanent Secretary of the Ministry of Public Health, Nonthaburi, Thailand;

关键词: COVID-19;    Interrupted time-series;    Lockdown;    Outpatient department;    Thailand;    Universal coverage scheme;   

DOI  :  10.1186/s12913-023-09121-3

 received in 2022-10-06, accepted in 2023-01-30,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundOut-patient department (OPD) is a crucial component of the healthcare systems in low- and middle-income countries including Thailand. A considerable impact of coronavirus disease 2019 (COVID-19) pandemic and its control measures, especially the lockdown, on utilisation of OPD services was expected. This study thus aims to estimate the pattern of OPD utilisation during the COVID-19 pandemic in Thailand including overall utilisation and within each sub-groups including diagnostic group, age group, and health region.MethodsThis study was a secondary data analysis of aggregated outpatient data from patients covered under the Universal Coverage Scheme (UCS) in Thailand over a 4-year period (2017–2020). Interrupted time series analyses and segmented Quasi-Poisson regression were used to examine the impact of COVID-19 on the overall OPD utilisation including the impact on each diagnostic group, age groups, health regions, and provinces.ResultsAnalysis of 845,344,946 OPD visits in this study showed a seasonal pattern and increasing trend in monthly OPD visits before the COVID-19 pandemic. A 28% (rate ratio (RR) 0.718, 95% confidence interval (CI): 0.631–0.819) and 11% (RR 0.890, 95% CI: 0.811–0.977) reduction in OPD visits was observed during the lockdown and post-lockdown periods, respectively, when compared to the pre-lockdown period. Diseases of respiratory system were most affected with a RR of 0.411 (95% CI: 0.320–0.527), while the number of visits for non-communicable diseases (ICD-10: E00–E90, I00–I99) and elderly (> 60 years) dropped slightly. The post-lockdown trend in monthly OPD visits gradually increased to the pre-pandemic levels in most groups.ConclusionsThailand’s OPD utilisation rate during the COVID-19 lockdown decreased in some diseases, but the service for certain group of patients appeared to remain available. After the COVID-19 lockdown, the rate returned to the pre-pandemic level in a timely manner. Equipped with a knowledge of OPD utilisation pattern during COVID-19 based on a national real-world database could aid with a better preparation of healthcare system for future pandemics.

【 授权许可】

CC BY   
© The Author(s) 2023

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