Associations of the COVID-19 pandemic with older individuals' healthcare utilization and self-reported health status: a longitudinal analysis from Singapore

• Published in: BMC health services research 2022-01, Vol.22 (1), p.66-66, Article 66
• Main Authors: Ahn, SangNam, Kim, Seonghoon, Koh, Kanghyock
• Format: Article
• Language: English
• Subjects: Aged; Chronic illnesses; Communicable Disease Control; Coronaviruses; COVID-19; Delivery of Health Care; Epidemics; Health aspects; Health care expenditures; Health care policy; Health services utilization; Health Status; Healthcare spending; Healthcare utilization; Humans; Influence; Internet access; Medical care; Medical savings accounts; Middle Aged; Older people; Pandemic; Pandemics; Patient Acceptance of Health Care; SARS-CoV-2; Self Report; Self-reported health status; Singapore; Singapore - epidemiology; Utilization; Variables
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/s12913-021-07446-5

The COVID-19 pandemic has challenged the capacity of healthcare systems around the world and can potentially compromise healthcare utilization and health outcomes among non-COVID-19 patients. To examine the associations of the COVID-19 pandemic with healthcare utilization, out-of-pocket medical costs, and perceived health among middle-aged and older individuals in Singapore. Utilizing data collected from a monthly panel survey, a difference-in-differences approach was used to characterize monthly changes of healthcare use and spending and estimate the probability of being diagnosed with a chronic condition and self-reported health status before and during the COVID-19 outbreak in 2020. Data were analyzed from 7569 nationally representative individuals from 2019 January and 2020 December. Healthcare utilization and healthcare spending by medical service categories as well as self-reported health status. Between January and April 2020 (the first peak period of COVID-19 in Singapore), doctor visits decreased by 30%, and out-of-pocket medical spending decreased by 23%, mostly driven by reductions in inpatient and outpatient care. As a result, the probability of any diagnosis of chronic conditions decreased by 19% in April 2020. The decreased healthcare utilization and spending recovered after lifting the national lockdown in June, 2020 and remained similar to the pre-pandemic level through the rest of 2020. Middle-aged and older Singaporeans' healthcare utilization and the diagnosis of chronic conditions substantially decreased during the first peak period of the COVID-19 outbreak. Further studies to track the longer-term health effect of the pandemic among non-COVID-19 patients are warranted.