Impact of COVID-19 on primary care visits: lesson learnt from the early pandemic period

https://doi.org/10.22146/jcoemph.57918

Sholahuddin Rhatomy(1*), Thomas Edison Prasetyo(2)

(1) Sport and Adult Reconstruction Division, Department of Orthopaedics and Traumatology, Dr. Soeradji Tirtonegoro General Hospital, Klaten, Indonesia; Department of Surgery, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
(2) Soeradji Tirtonegoro Sport and Research Unit, Dr Soeradji Tirtonegoro General Hospital, Klaten, Indonesia Internship Medical Doctor of Puskesmas Bayat, Klaten Indonesia
(*) Corresponding Author

Abstract


In Indonesia, primary healthcare facilities play important roles in disease control and prevention. Changes in healthcare seeking behavior during the COVID-19 pandemic, especially to primary care, might have impacts to the overall public health status. This comparative epidemiology study aimed to investigate the changes of healthcare seeking behavior in primary care settings during the early pandemic period. Weekly number of visits to a primary healthcare facility in Klaten, Indonesia was examined from the 1st week of 2018 –through the 25th week of 2020. The selected period affected early by COVID-19 in 2020 was defined (early pandemic period) and compared to the same corresponding period in 2019 (comparison period). The total number of patient visits, number of visits by age, gender, clinical decisions, patient status and diagnostic categories were obtained, compared and analyzed. Mean differences and prevalence ratio of a specific diagnostic category between the two periods were calculated. The lowest period was from weeks 14 – 21, 2020, which we identified as the early pandemic period. Comparing the early pandemic period to the comparison period, we found that there was 46.3% decrease of total number of visits. The decline was especially apparent for children aged 0-9 (71%), females (46%), registered patients (49%) and outpatients (48%). Most of diagnostic categories also saw declines. Unfortunately, patients with hypertension also saw notable decline in mean differences and prevalence ratio albeit not desirable. In conclusion, some declines in the number of visits were not desirable including decreasing hypertension visit. This trend might negatively impact public health status afterward. Proper countermeasures are needed to control the ongoing trend. Further studies regarding the impact of COVID-19 on treatment seeking behavior is needed to plan effective countermeasures.

Keywords


epidemiology study; COVID-19; primary care

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References

  1. WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020. https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020. Accessed May 24, 2020.
  2. Jokowi declares COVID-19 health emergency, imposes large-scale social restrictions - National - The Jakarta Post. https://www.thejakartapost.com/news/2020/03/31/jokowi-declares-covid-19-health-emergency-imposes-large-scale-social-restrictions.html. Accessed July 13, 2020.
  3. Situasi Terkini Perkembangan Coronavirus Disease (COVID-19) 13 Juli 2020 » Info Infeksi Emerging Kementerian Kesehatan RI. https://covid19.kemkes.go.id/situasi-infeksi-emerging/info-corona-virus/situasi-terkini-perkembangan-coronavirus-disease-covid-19-13-juli-2020/#.XwwBUSgzbIU. Accessed July 13, 2020.
  4. Q&A on coronaviruses (COVID-19). https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/q-a-coronaviruses. Accessed May 24, 2020.
  5. Yuki K, Fujiogi M, Koutsogiannaki S. COVID-19 pathophysiology: a review. Clin Immunol. 2020;215:108427. doi:10.1016/j.clim.2020.108427
  6. SARS | Frequently Asked Questions | CDC. https://www.cdc.gov/sars/about/faq.html. Accessed May 24, 2020.
  7. Bertolino L, Vitrone M, Durante-Mangoni E. Does this patient have COVID-19?: a practical guide for the internist. Intern Emerg Med. May 2020. doi:10.1007/s11739-020-02377-1
  8. Advice for public. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public. Accessed May 24, 2020.
  9. Laura E. Wong; MD; PhD; Jessica E. Hawkins; MSEd; Simone Langness; Karen L. Murrell; Patricia Iris; MD & Amanda Sammann; MPH. Where are all the patients? addressing COVID-19 fear to encourage sick patients to seek emergency care. NEJM Catal. 2020; (Figure 1):1-12. doi:https://catalyst.nejm.org/doi/abs/10.1056/CAT.20.0193
  10. Santoli JM, Lindley MC, DeSilva MB, et al. Effects of the COVID-19 pandemic on routine pediatric vaccine ordering and administration - United States, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(19):591-593. doi:10.15585/mmwr.mm6919e2
  11. Hartnett KP, Kite-Powell A, DeVies J, et al. Impact of the COVID-19 pandemic on emergency department visits - United States, January 1, 2019-May 30, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(23):699-704. doi:10.15585/mmwr.mm6923e1
  12. Bres Bullrich M, Fridman S, Mandzia JL, et al. COVID-19: Stroke admissions, emergency department visits, and prevention clinic referrals. Can J Neurol Sci / J Can des Sci Neurol. 2020:1-4. doi:10.1017/cjn.2020.101
  13. Bjørnsen LP, Næss-Pleym LE, Dale J, Laugsand LE. Patient visits to an emergency department in anticipation of the COVID-19 pandemic. Tidsskr Nor Laegeforen. 2020;140(8). doi:10.4045/tidsskr.20.0277
  14. Mauro V, Lorenzo M, Paolo C, Sergio H. Treat all COVID 19-positive patients, but do not forget those negative with chronic diseases. Intern Emerg Med. 2020;(0123456789):3-6. doi:10.1007/s11739-020-02395-z
  15. Metzler B, Siostrzonek P, Binder RK, Bauer A, Reinstadler SJ. Decline of acute coronary syndrome admissions in Austria since the outbreak of COVID-19: the pandemic response causes cardiac collateral damage. Eur Heart J. 2020;41(19):1852-1853. doi:10.1093/eurheartj/ehaa314
  16. Tsioufis K, Chrysohoou C, Kariori M, et al. The mystery of “missing” visits in an emergency cardiology department, in the era of COVID-19.; a time-series analysis in a tertiary Greek General Hospital. Clin Res Cardiol. 2020. doi:10.1007/s00392-020-01682-1
  17. Kutlu Ö, Günes R, Coerdt K, Metin A, Khachemoune A. Effect “stay‐at‐home” policy - dermatology outpatient visits COVID - TURKEY.pdf. Dermatol Ther. 2020. doi:10.1111/dth.13581
  18. Kulkarni P, Mahadevappa M. COVID-19 pandemic and the reduction in ST- elevation myocardial infarction admissions. Postgr Med J. 2020;(May):2019-2020. doi:10.1136/postgradmedj-2020-137895
  19. Tam CCF, Cheung KS, Lam S, et al. Impact of Coronavirus Disease 2019 (COVID-19) outbreak on ST-segment-elevation myocardial infarction care in Hong Kong, China. Circ Cardiovasc Qual Outcomes. 2020;2019(April):2019-2021. doi:10.1161/CIRCOUTCOMES.120.006631
  20. Badan Pusat Statistik Kabupaten Klaten. https://klatenkab.bps.go.id/publication/2019/09/26/0241917e5c44384d314767aa/kecamatan-bayat-dalam-angka-2019.html. Accessed August 12, 2020.
  21. Awasi Corona Kab.Klaten. https://awasicorona.klatenkab.go.id/#data. Accessed August 12, 2020.
  22. Instagram video by Humas Kab Klaten. Apr 16, 2020 at 9:24 PM. https://www.instagram.com/p/B_C3WitFJBB/. Accessed May 30, 2020.
  23. Klaten Tetapkan Status KLB Corona - Halaman 2. https://news.detik.com/berita-jawa-tengah/d-4961321/klaten-tetapkan-status-klb-corona/2. Accessed May 30, 2020.
  24. Humas Kab Klaten on Instagram: “Dihimbau kepada seluruh masyarakat Kab.Klaten untuk tidak panik namun tetap waspada. Jaga kesehatan dan jaga selalu kebersihan badan serta….” https://www.instagram.com/p/B9t9NrGFC21/. Accessed May 30, 2020.
  25. Wabah Corona, Tunda ke Dokter dan Perhatikan Waktu yang Tepat. https://www.cnnindonesia.com/gaya-hidup/20200324140651-284-486469/wabah-corona-tunda-ke-dokter-dan-perhatikan-waktu-yang-tepat. Accessed July 16, 2020.
  26. Amraei R, Rahimi N. COVID-19, Renin-angiotensin system and endothelial dysfunction. Cells. 2020;9(7):1-18. doi:10.3390/cells9071652
  27. Saxena T, Ali AO, Saxena M. Pathophysiology of essential hypertension: an update. Expert Rev Cardiovasc Ther. 2018;16(12):879-887. doi:10.1080/14779072.2018.1540301
  28. Williams DM, Nawaz A, Evans M. Diabetes and novel coronavirus infection: implications for treatment. Diabetes Ther. 2020. doi:10.1007/s13300-020-00858-2
  29. Bisanzio D, Kraemer MUG, Brewer T, Brownstein JS, Reithinger R. Geolocated Twitter social media data to describe the geographic spread of SARS-CoV-2. J Travel Med. July 2020. doi:10.1093/jtm/taaa120
  30. Basch CH, Hillyer GC, Jaime C. COVID-19 on TikTok: harnessing an emerging social media platform to convey important public health messages. Int J Adolesc Med Health. August 2020. doi:10.1515/ijamh-2020-0111
  31. Nesbitt C, Rath L, Yeh WZ, et al. MSCOVID19: using social media to achieve rapid dissemination of health information. Mult Scler Relat Disord. 2020;45. doi:10.1016/j.msard.2020.102338
  32. González-Padilla DA, Tortolero-Blanco L. Social media influence in the COVID-19 Pandemic. Int Braz J Urol. 2020;46(suppl.1):120-124. doi:10.1590/S1677-5538.IBJU.2020.S121
  33. Samy M, Abdelmalak R, Ahmed A, Kelada M. Social media as a source of medical information during COVID-19. Med Educ Online. 2020;25(1). doi:10.1080/10872981.2020.1791467
  34. Coronavirus Age, Sex, Demographics (COVID-19) - Worldometer. https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/. Accessed May 26, 2020.



DOI: https://doi.org/10.22146/jcoemph.57918

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