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. 2023 Jun;14(3):180-187.
doi: 10.24171/j.phrp.2023.0041. Epub 2023 Jun 22.

The COVID-19 pandemic and healthcare utilization in Iran: evidence from an interrupted time series analysis

Monireh Mahmoodpour-Azari  1 , Satar Rezaei  1 , Nasim Badiee  2   3 , Mohammad Hajizadeh  4 , Ali Mohammadi  5 , Ali Kazemi-Karyani  1 , Shahin Soltani  1 , Mehdi Khezeli  6
Affiliations

The COVID-19 pandemic and healthcare utilization in Iran: evidence from an interrupted time series analysis

Monireh Mahmoodpour-Azari et al. Osong Public Health Res Perspect. 2023 Jun.

Abstract

Background: This study aimed to examine the effect of the coronavirus disease 2019 (COVID-19) outbreak on the hospitalization rate, emergency department (ED) visits, and outpatient clinic visits in western Iran.

Methods: We collected data on the monthly hospitalization rate, rate of patients referred to the ED, and rate of patients referred to outpatient clinics for a period of 40 months (23 months before and 17 months after the COVID-19 outbreak in Iran) from all 7 public hospitals in the city of Kermanshah. An interrupted time series analysis was conducted to examine the impact of COVID-19 on the outcome variables in this study.

Results: A statistically significant decrease of 38.11 hospitalizations per 10,000 population (95% confidence interval [CI], 24.93-51.29) was observed in the first month of the COVID-19 outbreak. The corresponding reductions in ED visits and outpatient visits per 10,000 population were 191.65 (95% CI, 166.63-216.66) and 168.57 (95% CI, 126.41-210.73), respectively. After the initial reduction, significant monthly increases in the hospitalization rate (an increase of 1.81 per 10,000 population), ED visits (an increase of 2.16 per 10,000 population), and outpatient clinic visits (an increase of 5.77 per 10,000 population) were observed during the COVID-19 pandemic.

Conclusion: Our study showed that the utilization of outpatient and inpatient services in hospitals and clinics significantly declined after the COVID-19 outbreak, and use of these services did not return to pre-outbreak levels as of June 2021.

Keywords: COVID-19; Hospital outpatient clinic; Iran; Patient care.

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Conflict of interest statement

Conflicts of Interest

The authors have no conflicts of interest to declare.

Figures

Figure 1.
Figure 1.
Interrupted time series analysis with Newey-West standard errors and 2 lags for the hospitalization rate per 10,000 population. The initial outbreak occurred on February 19, 2020.
Figure 2.
Figure 2.
Interrupted time series analysis with Newey-West standard errors and 2 lags for emergency department visits per 10,000 population. The initial outbreak occurred on February 19, 2020.
Figure 3.
Figure 3.
Interrupted time series analysis with Newey-West standard errors and 2 lags for outpatient clinic visits per 10,000 population. The initial outbreak occurred on February 19, 2020.
See this image and copyright information in PMC

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