Abstract
Introduction: The COVID-19 pandemic had impacted the accessibility of essential health services worldwide which was manifested as reduced utilisation of the services throughout the pandemic period. One of the health services that had revealed a significant drop in utilisation globally was the general outpatient services in the primary care setting that caters for arrays of healthcare needs of the general population. This study quantified the changes in utilisation of outpatient services in public primary care health clinics throughout Malaysia during the COVID-19 pandemic.
Method: The monthly total number of outpatient visits was extracted from administrative routine data of the Ministry of Health from 1 January 2019 until 30 June 2021 covering all public health clinics nationwide. Monthly differences in outpatient visit between the pandemic year and pre-pandemic year (2019 vs 2020 and 2019 vs 2021) was examined using the paired t-test performed through the SPSS ver.26. Monthly outpatient visits per capita were analysed for each administrative district and a quarterly choropleth map was generated using QGIS software version 3.18 to depict the spatio-temporal changes in outpatient visit per capita by districts in Malaysia during the pandemic as compared to the pre-pandemic year.
Results: The total monthly outpatient visits showed significant reduction (p<0.05) ranging from 16.9% - 38.4% monthly starting from April 2020 until June 2021 as compared to respective month in 2019. The greatest reduction was seen in April 2020 (38.4%), followed by May 2020 (37.7%) and July 2020 (28.5%). A similar pattern was observed in both follow-up and new-cases attendances. The quarterly choropleth map showed all districts experienced reduction from April to June 2020 as compared to respective month in 2019, especially at the west coastal region of Peninsular Malaysia. Less than 10% of districts in Malaysia showed equal or increased outpatient visits per capita from April until June 2021.
Discussion: The substantial reductions in outpatient visits in the public health clinics corresponded to the implementation of the Movement Control Order (MCO) in March 2020. Despite being classified as an essential service that allows travel throughout the MCO, access to healthcare services remain limited. The fact that follow-up cases were equally affected as new-cases may indicate the collateral damage caused by a pandemic on the care continuity of chronic diseases. Only a minimal number of districts managed to recover their outpatient services utilisation to the pre-pandemic level 12 months after the pandemic started.
Links
- https://apcph.cphm.my/wp-content/uploads/2022/07/APCPH2022-O-55.pdf
- https://apcph.cphm.my/events/oral-session-4-ballroom-A/
BibTeX (Download)
@proceedings{APCPH2022-O-55,
title = {The impact of COVID-19 pandemic on outpatient service in public primary care clinics in Malaysia},
author = {Izzatur Rahmi MU and Normaizira H and Samsiah A and Nur Wahida Z and Jabrullah AH and Divya Nair N and Khalidah M and Nurhayati S and Roslina S and Mariyah M and Mohd Safiee I and Noridah MS and Rajini S},
url = {https://apcph.cphm.my/wp-content/uploads/2022/07/APCPH2022-O-55.pdf
https://apcph.cphm.my/events/oral-session-4-ballroom-A/},
year = {2022},
date = {2022-08-01},
urldate = {2022-08-02},
issue = {7},
abstract = {Introduction: The COVID-19 pandemic had impacted the accessibility of essential health services worldwide which was manifested as reduced utilisation of the services throughout the pandemic period. One of the health services that had revealed a significant drop in utilisation globally was the general outpatient services in the primary care setting that caters for arrays of healthcare needs of the general population. This study quantified the changes in utilisation of outpatient services in public primary care health clinics throughout Malaysia during the COVID-19 pandemic.
Method: The monthly total number of outpatient visits was extracted from administrative routine data of the Ministry of Health from 1 January 2019 until 30 June 2021 covering all public health clinics nationwide. Monthly differences in outpatient visit between the pandemic year and pre-pandemic year (2019 vs 2020 and 2019 vs 2021) was examined using the paired t-test performed through the SPSS ver.26. Monthly outpatient visits per capita were analysed for each administrative district and a quarterly choropleth map was generated using QGIS software version 3.18 to depict the spatio-temporal changes in outpatient visit per capita by districts in Malaysia during the pandemic as compared to the pre-pandemic year.
Results: The total monthly outpatient visits showed significant reduction (p\<0.05) ranging from 16.9% - 38.4% monthly starting from April 2020 until June 2021 as compared to respective month in 2019. The greatest reduction was seen in April 2020 (38.4%), followed by May 2020 (37.7%) and July 2020 (28.5%). A similar pattern was observed in both follow-up and new-cases attendances. The quarterly choropleth map showed all districts experienced reduction from April to June 2020 as compared to respective month in 2019, especially at the west coastal region of Peninsular Malaysia. Less than 10% of districts in Malaysia showed equal or increased outpatient visits per capita from April until June 2021.
Discussion: The substantial reductions in outpatient visits in the public health clinics corresponded to the implementation of the Movement Control Order (MCO) in March 2020. Despite being classified as an essential service that allows travel throughout the MCO, access to healthcare services remain limited. The fact that follow-up cases were equally affected as new-cases may indicate the collateral damage caused by a pandemic on the care continuity of chronic diseases. Only a minimal number of districts managed to recover their outpatient services utilisation to the pre-pandemic level 12 months after the pandemic started.},
howpublished = {published online at https://apcph.cphm.my},
note = {Type: ORAL PRESENTATION; Organisation: Institute for Health Systems Research, National Institutes of Health, MOH Malaysia, Faculty of Pharmacy, Universiti Teknologi MARA, Selangor; Hospital Tuanku Fauziah, Perlis; Family Health Development Division, MOH Malaysia},
keywords = {},
pubstate = {published},
tppubtype = {proceedings}
}