Impact of COVID-19 pandemic on utilisation of healthcare services: a systematic review.
Impact of COVID-19 pandemic on utilisation of healthcare services: a systematic review.
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DOI：
10.1136/bmjopen-2020-045343
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发表时间：
2021-03-16
期刊：
影响因子：
2.9
通讯作者：
Albarqouni L
中科院分区：
文献类型：
--
作者：
Moynihan R;Sanders S;Michaleff ZA;Scott AM;Clark J;To EJ;Jones M;Kitchener E;Fox M;Johansson M;Lang E;Duggan A;Scott I;Albarqouni L
厘定新型冠状病毒疫情期间医疗服务使用的变动程度及性质。系统评价。合资格研究将COVID-19疫情期间的服务使用情况与过往年度至少一个可比较期间进行比较。服务包括探视、入院、诊断和治疗。如果研究来自单中心或仅研究COVID-19患者，则将其排除。检索PubMed、Embase、科克伦COVID-19研究登记册和预印本，无语言限制，直到8月10日，使用包括COVID-19、卫生服务和影响在内的关键概念进行详细检索。通过调整非随机干预研究工具中的偏倚风险和科克伦有效实践和护理组织工具来评估偏倚风险。使用描述性统计、图形和叙述性综合对结果进行分析。主要结果为疫情前与疫情期间的服务使用率变化。次要结局是轻度或重度疾病（例如，分诊评分）的医疗保健服务使用者比例的变化。确定了3097个独特的参考文献，包括20个国家的81项研究，报告了大流行前超过1100万项服务和大流行期间的690万项服务。对于主要结局，有143个变化估计值，总体服务中位数减少37%（IQR-51%至-20%），包括访视中位数减少42%（-53%至-32%），入院中位数减少28%（-40%至-17%），诊断中位数减少31%（-53%至-24%）和治疗中位数减少30%（-57%至-19%）。在35项报告次要结局的研究中，有60项估计，其中27项（45%）报告了病情较轻人群的使用率大幅下降，33项（55%）报告没有差异。在疫情期间，医疗保健利用率下降了约三分之一，差异相当大，病情较轻的人群下降幅度更大。虽然解决未满足的需求仍然是一个优先事项，但对减少的健康影响的研究可能有助于卫生系统在大流行后恢复中减少不必要的护理。CRD 42020203729。
To determine the extent and nature of changes in utilisation of healthcare services during COVID-19 pandemic. Systematic review. 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. 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. 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. 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). 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. 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. CRD42020203729.
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影响因子：
15.8
作者：
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通讯作者：
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影响因子：
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DOI：
10.1093/jamia/ocaa072
发表时间：
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影响因子：
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作者：
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DOI：
10.34172/ijhpm.2020.66
发表时间：
2020-10-01
影响因子：
3.5
作者：
Auener S;Kroon D;Wackers E;Dulmen SV;Jeurissen P
通讯作者：
Jeurissen P