The impact of the early COVID-19 pandemic on healthcare system resource use and costs in two provinces in Canada: An interrupted time series analysis.

Autor: Zeitouny S; Canadian Centre for Applied Research in Cancer Control, BC Cancer, Vancouver, British Columbia, Canada.; Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada., Cheung DC; Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, Ontario, Canada.; Divisions of Urology and Surgical Oncology, Department of Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada., Bremner KE; Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, Ontario, Canada., Pataky RE; Canadian Centre for Applied Research in Cancer Control, BC Cancer, Vancouver, British Columbia, Canada.; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada., Pequeno P; ICES, Toronto, Ontario, Canada., Matelski J; Biostatistics Research Unit, University Health Network, Toronto, Ontario, Canada., Peacock S; Canadian Centre for Applied Research in Cancer Control, BC Cancer, Vancouver, British Columbia, Canada.; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada., Del Giudice ME; Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.; Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada., Lapointe-Shaw L; ICES, Toronto, Ontario, Canada.; Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada.; Department of General Internal Medicine, Toronto General Hospital, Toronto, Ontario, Canada., Tomlinson G; Biostatistics Research Unit, University Health Network, Toronto, Ontario, Canada., Mendlowitz AB; Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, Ontario, Canada.; Toronto Centre for Liver Disease/Viral Hepatitis Care Network (VIRCAN), University Health Network, Toronto, Ontario, Canada.; Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada., Mulder C; Chiefs of Ontario, Toronto, Ontario, Canada.; Queen's University, Kingston, Ontario, Canada., Tsui TCO; ICES, Toronto, Ontario, Canada.; Child Health and Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada.; Sunnybrook Research Institute, Toronto, Ontario, Canada.; Canadian Centre for Applied Research in Cancer Control, Ontario Health-Cancer Care Ontario, Toronto, Ontario, Canada., Perlis N; Divisions of Urology and Surgical Oncology, Department of Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.; Division of Urology, Sprott Department of Surgery, University Health Network, Cancer Clinical Research Unit, Princess Margaret Cancer Centre, Toronto, Ontario, Canada., Walker JD; ICES, Toronto, Ontario, Canada.; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada., Sander B; Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, Ontario, Canada.; ICES, Toronto, Ontario, Canada.; Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada.; Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada., Wong WWL; ICES, Toronto, Ontario, Canada.; School of Pharmacy, University of Waterloo, Kitchener, Ontario, Canada., Krahn MD; Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, Ontario, Canada.; ICES, Toronto, Ontario, Canada.; Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada.; Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada., Kulkarni GS; Divisions of Urology and Surgical Oncology, Department of Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.; ICES, Toronto, Ontario, Canada.; Division of Urology, Sprott Department of Surgery, University Health Network, Cancer Clinical Research Unit, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2023 Sep 08; Vol. 18 (9), pp. e0290646. Date of Electronic Publication: 2023 Sep 08 (Print Publication: 2023).
DOI: 10.1371/journal.pone.0290646
Abstrakt: Introduction: The aim of our study was to assess the initial impact of COVID-19 on total publicly-funded direct healthcare costs and health services use in two Canadian provinces, Ontario and British Columbia (BC).
Methods: This retrospective repeated cross-sectional study used population-based administrative datasets, linked within each province, from January 1, 2018 to December 27, 2020. Interrupted time series analysis was used to estimate changes in the level and trends of weekly resource use and costs, with March 16-22, 2020 as the first pandemic week. Also, in each week of 2020, we identified cases with their first positive SARS-CoV-2 test and estimated their healthcare costs until death or December 27, 2020.
Results: The resources with the largest level declines (95% confidence interval) in use in the first pandemic week compared to the previous week were physician services [Ontario: -43% (-49%,-37%); BC: -24% (-30%,-19%) (both p<0.001)] and emergency department visits [Ontario: -41% (-47%,-35%); BC: -29% (-35%,-23%) (both p<0.001)]. Hospital admissions declined by 27% (-32%,-23%) in Ontario and 21% (-26%,-16%) in BC (both p<0.001). Resource use subsequently rose but did not return to pre-pandemic levels. Only home care and dialysis clinic visits did not significantly decrease compared to pre-pandemic. Costs for COVID-19 cases represented 1.3% and 0.7% of total direct healthcare costs in 2020 in Ontario and BC, respectively.
Conclusions: Reduced utilization of healthcare services in the overall population outweighed utilization by COVID-19 patients in 2020. Meeting the needs of all patients across all services is essential to maintain resilient healthcare systems.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2023 Zeitouny et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje