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. 2022 Jan;52(1):42-48.
doi: 10.1111/imj.15501.

Impact of COVID-19 restrictions on pathology service utilisation

Marianne H Gillam  1 , Elizabeth Roughead  1 , Rosanna Tavella  2 , Tom Dodd  3   4 , John Beltrame  2 , Richard Ryan  3 , Peter O'Loughlin  3   4
Affiliations

Impact of COVID-19 restrictions on pathology service utilisation

Marianne H Gillam et al. Intern Med J. 2022 Jan.

Abstract

Background: Isolation and social distancing restrictions due to COVID-19 have the potential to impact access to healthcare services.

Aims: To assess the use of pathology services during the COVID-19 pandemic initial restrictions.

Methods: Repeated cross-sectional study of pathology tests utilisation during a baseline time period early in 2020 compared with pre-lockdown and lockdown due to COVID-19 in South Australia. The outcome measure was changed in a number of pathology tests compared to baseline period, particularly change in the number of troponin tests to determine potential impacts of lockdown on urgent care presentations.

Results: In the community setting, the ratio of a number of pathology tests pre-lockdown and post-lockdown versus baseline period decreased from 1.02 to 0.53 respectively. The exception was microbiology molecular tests, where the number of tests was more than three times higher in the lockdown period. The number of troponin tests in emergency departments decreased in the lockdown period compared to the baseline time period; however, there was no evidence of an association between tests result (positive vs negative) and time period (odds ratio (OR) 1.09; 95% confidence interval (CI) 0.97-1.22). There was an inverse relationship between age and time period (OR 0.995; 95% CI 0.993-0.997), indicating that fewer troponin tests were conducted in older people during the lockdown compared with the baseline period.

Conclusion: COVID-19 restrictions had a significant impact on the use of pathology testing in both urgent and non-urgent care settings. Further studies are needed to investigate the effect on health outcomes as a result of the COVID-19 restrictions.

Keywords: COVID-19; pathology services; troponin.

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Figures

Figure 1
Figure 1
Ratio of number of pathology tests per week compared with average number of weekly tests in the baseline period (weeks 5–8) in 2019 and 2020 ordered by physicians in the community setting superimposed on number of COVID‐19 cases in South Australia over the same period. (formula image), Ratio2019; (formula image), ratio 2020; (formula image), number of COVID‐19 cases.
Figure 2
Figure 2
Ratio of number of pathology tests per week compared to average number of weekly tests in the baseline period (weeks 5–8) in 2019 and 2020 ordered in ED superimposed on number of COVID‐19 cases in South Australia over the same period. (formula image), Ratio2019; (formula image), ratio 2020; (formula image), number of COVID‐19 cases.
Figure 3
Figure 3
Ratio of number of tests performed in lockdown (i.e. weeks 12–15) to number of tests performed in the baseline period (i.e. weeks 5–8) in the community. AP, anatomical pathology; Micro M, microbiology molecular; Micro NM, microbiology non‐molecular.
Figure 4
Figure 4
Age distribution of troponin tests in the (formula image) baseline period (weeks 5–8 2020: 27 January–23 February) compared with (formula image) lockdown (weeks 12–15 2020: 16 March–12 April) recorded by SA pathology. Inset: Same time periods in 2019.
See this image and copyright information in PMC

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