Impact of COVID-19 on disease-specific mortality, healthcare resource utilization, and disease burden across a population over 1 billion in 31 countries: an interrupted time-series analysisResearch in context
Summary: Background: The COVID-19 pandemic disrupted global health and affected chronic disease management. This study quantified the impact of the pandemic on disease-specific measures of health dynamics, such as mortality rates, healthcare resource utilization (HRU), and disease burden. Methods:...
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Elsevier
2025-07-01
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| Series: | EClinicalMedicine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537025002470 |
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| author | Kyungseon Choi Minseol Jang Siin Kim Sang Jun Park Hae Sun Suh |
| author_facet | Kyungseon Choi Minseol Jang Siin Kim Sang Jun Park Hae Sun Suh |
| author_sort | Kyungseon Choi |
| collection | DOAJ |
| description | Summary: Background: The COVID-19 pandemic disrupted global health and affected chronic disease management. This study quantified the impact of the pandemic on disease-specific measures of health dynamics, such as mortality rates, healthcare resource utilization (HRU), and disease burden. Methods: An interrupted time-series analysis was performed by examining temporal trends across disease categories over two periods: pre-pandemic and pandemic (after January 2020). Monthly mortality data were collected from 31 countries, while monthly HRU and disease burden data were collected from South Korea. We defined primary outcomes as disease-specific mortality rate, number of patients, outpatient visits, days of hospitalization, disease burden, and per capita cost. We used a generalized least squares model with AR (1) residuals and an automated SARIMA model and Benjamini–Hochberg-adjusted q-values were applied for statistical significance (q < 0.05). Findings: A significant increase in disease-specific mortality was observed across multiple countries, with circulatory diseases showing the most widespread rise. HRU declined across most disease categories, including reductions in patient numbers, outpatient visits, and hospital stays; however, patient number showed sustained increase in neoplasm and mental disorder. Although changes in total direct medical costs varied by disease, per capita costs initially increased despite a decrease in the number of patients. Interpretation: The pandemic led to increased mortality and disease burden with limited access to healthcare services. Establishing resilient healthcare systems and appropriate public health policies are key to ensure continuity of care during national crises. Funding: Ministry of Food and Drug Safety of Korea; National Research Foundation of Korea; Korean Government; Korea Environment Industry & Technology Institute. |
| format | Article |
| id | doaj-art-95944464667d439cbb6a3c7f54f96df2 |
| institution | Kabale University |
| issn | 2589-5370 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj-art-95944464667d439cbb6a3c7f54f96df22025-08-20T03:31:27ZengElsevierEClinicalMedicine2589-53702025-07-018510331510.1016/j.eclinm.2025.103315Impact of COVID-19 on disease-specific mortality, healthcare resource utilization, and disease burden across a population over 1 billion in 31 countries: an interrupted time-series analysisResearch in contextKyungseon Choi0Minseol Jang1Siin Kim2Sang Jun Park3Hae Sun Suh4Department of Regulatory Science, Graduate School, Kyung Hee University, Seoul, Republic of Korea; Institute of Regulatory Innovation through Science, Kyung Hee University, Seoul, Republic of KoreaDepartment of Regulatory Science, Graduate School, Kyung Hee University, Seoul, Republic of Korea; Institute of Regulatory Innovation through Science, Kyung Hee University, Seoul, Republic of KoreaDepartment of Pharmacy, College of Pharmacy, Kyungsung University, Busan, Republic of KoreaDepartment of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; Corresponding author. 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea.Department of Regulatory Science, Graduate School, Kyung Hee University, Seoul, Republic of Korea; Institute of Regulatory Innovation through Science, Kyung Hee University, Seoul, Republic of Korea; Department of Pharmacy, College of Pharmacy, Kyung Hee University, Seoul, Republic of Korea; Corresponding author. 26, Kyunghee-daero, Dongdaemun-gu, Seoul 02447, Republic of Korea.Summary: Background: The COVID-19 pandemic disrupted global health and affected chronic disease management. This study quantified the impact of the pandemic on disease-specific measures of health dynamics, such as mortality rates, healthcare resource utilization (HRU), and disease burden. Methods: An interrupted time-series analysis was performed by examining temporal trends across disease categories over two periods: pre-pandemic and pandemic (after January 2020). Monthly mortality data were collected from 31 countries, while monthly HRU and disease burden data were collected from South Korea. We defined primary outcomes as disease-specific mortality rate, number of patients, outpatient visits, days of hospitalization, disease burden, and per capita cost. We used a generalized least squares model with AR (1) residuals and an automated SARIMA model and Benjamini–Hochberg-adjusted q-values were applied for statistical significance (q < 0.05). Findings: A significant increase in disease-specific mortality was observed across multiple countries, with circulatory diseases showing the most widespread rise. HRU declined across most disease categories, including reductions in patient numbers, outpatient visits, and hospital stays; however, patient number showed sustained increase in neoplasm and mental disorder. Although changes in total direct medical costs varied by disease, per capita costs initially increased despite a decrease in the number of patients. Interpretation: The pandemic led to increased mortality and disease burden with limited access to healthcare services. Establishing resilient healthcare systems and appropriate public health policies are key to ensure continuity of care during national crises. Funding: Ministry of Food and Drug Safety of Korea; National Research Foundation of Korea; Korean Government; Korea Environment Industry & Technology Institute.http://www.sciencedirect.com/science/article/pii/S2589537025002470COVID-19ImpactGlobal healthHealthcare resource utilizationMortalityInterrupted-time series analysis |
| spellingShingle | Kyungseon Choi Minseol Jang Siin Kim Sang Jun Park Hae Sun Suh Impact of COVID-19 on disease-specific mortality, healthcare resource utilization, and disease burden across a population over 1 billion in 31 countries: an interrupted time-series analysisResearch in context EClinicalMedicine COVID-19 Impact Global health Healthcare resource utilization Mortality Interrupted-time series analysis |
| title | Impact of COVID-19 on disease-specific mortality, healthcare resource utilization, and disease burden across a population over 1 billion in 31 countries: an interrupted time-series analysisResearch in context |
| title_full | Impact of COVID-19 on disease-specific mortality, healthcare resource utilization, and disease burden across a population over 1 billion in 31 countries: an interrupted time-series analysisResearch in context |
| title_fullStr | Impact of COVID-19 on disease-specific mortality, healthcare resource utilization, and disease burden across a population over 1 billion in 31 countries: an interrupted time-series analysisResearch in context |
| title_full_unstemmed | Impact of COVID-19 on disease-specific mortality, healthcare resource utilization, and disease burden across a population over 1 billion in 31 countries: an interrupted time-series analysisResearch in context |
| title_short | Impact of COVID-19 on disease-specific mortality, healthcare resource utilization, and disease burden across a population over 1 billion in 31 countries: an interrupted time-series analysisResearch in context |
| title_sort | impact of covid 19 on disease specific mortality healthcare resource utilization and disease burden across a population over 1 billion in 31 countries an interrupted time series analysisresearch in context |
| topic | COVID-19 Impact Global health Healthcare resource utilization Mortality Interrupted-time series analysis |
| url | http://www.sciencedirect.com/science/article/pii/S2589537025002470 |
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