Insights into the morbidity profiles of epidemiologically excluded COVID-19 patients in primary care settings during the third wave of the pandemic in the Anuradhapura District, Sri Lanka
Abstract Background The COVID-19 pandemic has dramatically impacted healthcare systems worldwide, leading to changes in the delivery of healthcare services. A profound effect on the well-being of non-COVID-19 patients has been reported, but limited evidence is available from developing countries. Th...
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BMC
2025-04-01
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| Series: | BMC Primary Care |
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| Online Access: | https://doi.org/10.1186/s12875-025-02792-3 |
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| author | Parami Abeyrathna Suneth Buddhika Agampodi Shyamalee Samaranayake Pahala Hangidi Gedara Janaka Pushpakumara |
| author_facet | Parami Abeyrathna Suneth Buddhika Agampodi Shyamalee Samaranayake Pahala Hangidi Gedara Janaka Pushpakumara |
| author_sort | Parami Abeyrathna |
| collection | DOAJ |
| description | Abstract Background The COVID-19 pandemic has dramatically impacted healthcare systems worldwide, leading to changes in the delivery of healthcare services. A profound effect on the well-being of non-COVID-19 patients has been reported, but limited evidence is available from developing countries. This study aimed to describe the morbidity profiles of epidemiologically excluded COVID-19 patients during the pandemic in the primary care setting of the Anuradhapura District of Sri Lanka. Methods This cross-sectional healthcare institution-based study collected morbidity profiles from six state-owned and five private primary care facilities (PCFs) in the Anuradhapura District during the third wave of the COVID-19 pandemic. Reasons for Encounters (RFEs) were recorded from physically available and epidemiologically excluded COVID-19 patients in a paper-based data format and coded using the International Classification of Primary Care. Results Out of 1630 primary care encounters, 187 RFEs were identified. Most patients were females (n = 899, 55%) and in the adult age category (n = 1297, 79%). The median age of the patients was 39 years (interquartile range: 21–55). Older patients were likelier to seek primary care in the state sector (p < .001). Most children presented to the private sector compared to state PCFs (p < 0.001). The majority of females significantly utilised state sector PCFs (p = 0.043). Upper respiratory tract infections (n = 154, 9.00%) were the most common RFE. The highest burden of systemic RFEs was associated with dermatological (n = 294, 18%) and respiratory conditions (n = 274, 16%). More than one-third of adults (n = 487, 37.5%) suffered from a self-reported non-communicable disease (NCD). Hypertension (n = 235, 48%), diabetes mellitus (n = 184, 38%), and dyslipidemia (n = 134, 28%) were the most observed NCDs. Multimorbidity was reported in 195 (40%) adult patients with an NCD. Conclusion The pandemic has led to a shift in primary care morbidity profiles, with a higher incidence of dermatological and respiratory diseases and NCDs among healthcare seekers. Patients sought care from the state and private sector differently depending on age, sex, and nature of illness. Primary care services must prepare to adapt to changes in healthcare-seeking patterns and morbidity profiles during pandemics to ensure comprehensive care is available on demand. |
| format | Article |
| id | doaj-art-d58f7c48890a4be2876d2c2ff652bbcc |
| institution | DOAJ |
| issn | 2731-4553 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Primary Care |
| spelling | doaj-art-d58f7c48890a4be2876d2c2ff652bbcc2025-08-20T03:04:51ZengBMCBMC Primary Care2731-45532025-04-0126111010.1186/s12875-025-02792-3Insights into the morbidity profiles of epidemiologically excluded COVID-19 patients in primary care settings during the third wave of the pandemic in the Anuradhapura District, Sri LankaParami Abeyrathna0Suneth Buddhika Agampodi1Shyamalee Samaranayake2Pahala Hangidi Gedara Janaka Pushpakumara3Department of Family Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri LankaCenter for Public HealthDepartment of Family Medicine, Faculty of Medical Sciences, University of Sri JayawardhanapuraDepartment of Family Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri LankaAbstract Background The COVID-19 pandemic has dramatically impacted healthcare systems worldwide, leading to changes in the delivery of healthcare services. A profound effect on the well-being of non-COVID-19 patients has been reported, but limited evidence is available from developing countries. This study aimed to describe the morbidity profiles of epidemiologically excluded COVID-19 patients during the pandemic in the primary care setting of the Anuradhapura District of Sri Lanka. Methods This cross-sectional healthcare institution-based study collected morbidity profiles from six state-owned and five private primary care facilities (PCFs) in the Anuradhapura District during the third wave of the COVID-19 pandemic. Reasons for Encounters (RFEs) were recorded from physically available and epidemiologically excluded COVID-19 patients in a paper-based data format and coded using the International Classification of Primary Care. Results Out of 1630 primary care encounters, 187 RFEs were identified. Most patients were females (n = 899, 55%) and in the adult age category (n = 1297, 79%). The median age of the patients was 39 years (interquartile range: 21–55). Older patients were likelier to seek primary care in the state sector (p < .001). Most children presented to the private sector compared to state PCFs (p < 0.001). The majority of females significantly utilised state sector PCFs (p = 0.043). Upper respiratory tract infections (n = 154, 9.00%) were the most common RFE. The highest burden of systemic RFEs was associated with dermatological (n = 294, 18%) and respiratory conditions (n = 274, 16%). More than one-third of adults (n = 487, 37.5%) suffered from a self-reported non-communicable disease (NCD). Hypertension (n = 235, 48%), diabetes mellitus (n = 184, 38%), and dyslipidemia (n = 134, 28%) were the most observed NCDs. Multimorbidity was reported in 195 (40%) adult patients with an NCD. Conclusion The pandemic has led to a shift in primary care morbidity profiles, with a higher incidence of dermatological and respiratory diseases and NCDs among healthcare seekers. Patients sought care from the state and private sector differently depending on age, sex, and nature of illness. Primary care services must prepare to adapt to changes in healthcare-seeking patterns and morbidity profiles during pandemics to ensure comprehensive care is available on demand.https://doi.org/10.1186/s12875-025-02792-3Primary careMorbidityCOVID-19 pandemicNon-communicable diseasesHealthcare utilisation |
| spellingShingle | Parami Abeyrathna Suneth Buddhika Agampodi Shyamalee Samaranayake Pahala Hangidi Gedara Janaka Pushpakumara Insights into the morbidity profiles of epidemiologically excluded COVID-19 patients in primary care settings during the third wave of the pandemic in the Anuradhapura District, Sri Lanka BMC Primary Care Primary care Morbidity COVID-19 pandemic Non-communicable diseases Healthcare utilisation |
| title | Insights into the morbidity profiles of epidemiologically excluded COVID-19 patients in primary care settings during the third wave of the pandemic in the Anuradhapura District, Sri Lanka |
| title_full | Insights into the morbidity profiles of epidemiologically excluded COVID-19 patients in primary care settings during the third wave of the pandemic in the Anuradhapura District, Sri Lanka |
| title_fullStr | Insights into the morbidity profiles of epidemiologically excluded COVID-19 patients in primary care settings during the third wave of the pandemic in the Anuradhapura District, Sri Lanka |
| title_full_unstemmed | Insights into the morbidity profiles of epidemiologically excluded COVID-19 patients in primary care settings during the third wave of the pandemic in the Anuradhapura District, Sri Lanka |
| title_short | Insights into the morbidity profiles of epidemiologically excluded COVID-19 patients in primary care settings during the third wave of the pandemic in the Anuradhapura District, Sri Lanka |
| title_sort | insights into the morbidity profiles of epidemiologically excluded covid 19 patients in primary care settings during the third wave of the pandemic in the anuradhapura district sri lanka |
| topic | Primary care Morbidity COVID-19 pandemic Non-communicable diseases Healthcare utilisation |
| url | https://doi.org/10.1186/s12875-025-02792-3 |
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