Reduction in healthcare services during the COVID-19 pandemic in China
Introduction The COVID-19 pandemic caused a healthcare crisis in China and continues to wreak havoc across the world. This paper evaluated COVID-19’s impact on national and regional healthcare service utilisation and expenditure in China.Methods Using a big data approach, we collected data from 300 ...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2020-11-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/5/11/e003421.full |
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| author | Fei Yan Ying Wang Yun Chen Fan Li Na Wang Yi-Na Zhang Michelle Pender Xiao-Hua Ying Sheng-Lan Tang Chao-Wei Fu |
| author_facet | Fei Yan Ying Wang Yun Chen Fan Li Na Wang Yi-Na Zhang Michelle Pender Xiao-Hua Ying Sheng-Lan Tang Chao-Wei Fu |
| author_sort | Fei Yan |
| collection | DOAJ |
| description | Introduction The COVID-19 pandemic caused a healthcare crisis in China and continues to wreak havoc across the world. This paper evaluated COVID-19’s impact on national and regional healthcare service utilisation and expenditure in China.Methods Using a big data approach, we collected data from 300 million bank card transactions to measure individual healthcare expenditure and utilisation in mainland China. Since the outbreak coincided with the 2020 Chinese Spring Festival holiday, a difference-in-difference (DID) method was employed to compare changes in healthcare utilisation before, during and after the Spring Festival in 2020 and 2019. We also tracked healthcare utilisation before, during and after the outbreak.Results Healthcare utilisation declined overall, especially during the post-festival period in 2020. Total healthcare expenditure and utilisation declined by 37.8% and 40.8%, respectively, while per capita expenditure increased by 3.3%. In a subgroup analysis, we found that the outbreak had a greater impact on healthcare utilisation in cities at higher risk of COVID-19, with stricter lockdown measures and those located in the western region. The DID results suggest that, compared with low-risk cities, the pandemic induced a 14.8%, 26.4% and 27.5% reduction in total healthcare expenditure in medium-risk and high-risk cities, and in cities located in Hubei province during the post-festival period in 2020 relative to 2019, an 8.6%, 15.9% and 24.4% reduction in utilisation services; and a 7.3% and 18.4% reduction in per capita expenditure in medium-risk and high-risk cities, respectively. By the last week of April 2020, as the outbreak came under control, healthcare utilisation gradually recovered, but only to 79.9%–89.3% of its pre-outbreak levels.Conclusion The COVID-19 pandemic had a significantly negative effect on healthcare utilisation in China, evident by a dramatic decline in healthcare expenditure. While the utilisation level has gradually increased post-outbreak, it has yet to return to normal levels. |
| format | Article |
| id | doaj-art-e26c044d95bc4b479cb1da8782b8fd18 |
| institution | DOAJ |
| issn | 2059-7908 |
| language | English |
| publishDate | 2020-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Global Health |
| spelling | doaj-art-e26c044d95bc4b479cb1da8782b8fd182025-08-20T02:50:08ZengBMJ Publishing GroupBMJ Global Health2059-79082020-11-0151110.1136/bmjgh-2020-003421Reduction in healthcare services during the COVID-19 pandemic in ChinaFei Yan0Ying Wang1Yun Chen2Fan Li3Na Wang4Yi-Na Zhang5Michelle Pender6Xiao-Hua Ying7Sheng-Lan Tang8Chao-Wei Fu9Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, School of Public Health, Fudan University, Shanghai, ChinaDepartment of Pharmacy, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China7 Research Center for Clinical Oncology, Jiangsu Cancer Hospital, The Affiliated Cancer Hospital of 15 Nanjing Medical University, Nanjing, China1 Department of Neurology, Peking University First Hospital, Beijing, ChinaDepartment of Hematology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, ChinaDepartment of Socail Management and Socail Policy, School of Social Development and Public Policy, Fudan University, Shanghai, ChinaDuke Global Health Institute, Duke University, Durham, North Carolina, USAKey Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, School of Public Health, Fudan University, Shanghai, ChinaDuke Global Health Institute, Duke University, Durham, North Carolina, USAKey Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, School of Public Health, Fudan University, Shanghai, ChinaIntroduction The COVID-19 pandemic caused a healthcare crisis in China and continues to wreak havoc across the world. This paper evaluated COVID-19’s impact on national and regional healthcare service utilisation and expenditure in China.Methods Using a big data approach, we collected data from 300 million bank card transactions to measure individual healthcare expenditure and utilisation in mainland China. Since the outbreak coincided with the 2020 Chinese Spring Festival holiday, a difference-in-difference (DID) method was employed to compare changes in healthcare utilisation before, during and after the Spring Festival in 2020 and 2019. We also tracked healthcare utilisation before, during and after the outbreak.Results Healthcare utilisation declined overall, especially during the post-festival period in 2020. Total healthcare expenditure and utilisation declined by 37.8% and 40.8%, respectively, while per capita expenditure increased by 3.3%. In a subgroup analysis, we found that the outbreak had a greater impact on healthcare utilisation in cities at higher risk of COVID-19, with stricter lockdown measures and those located in the western region. The DID results suggest that, compared with low-risk cities, the pandemic induced a 14.8%, 26.4% and 27.5% reduction in total healthcare expenditure in medium-risk and high-risk cities, and in cities located in Hubei province during the post-festival period in 2020 relative to 2019, an 8.6%, 15.9% and 24.4% reduction in utilisation services; and a 7.3% and 18.4% reduction in per capita expenditure in medium-risk and high-risk cities, respectively. By the last week of April 2020, as the outbreak came under control, healthcare utilisation gradually recovered, but only to 79.9%–89.3% of its pre-outbreak levels.Conclusion The COVID-19 pandemic had a significantly negative effect on healthcare utilisation in China, evident by a dramatic decline in healthcare expenditure. While the utilisation level has gradually increased post-outbreak, it has yet to return to normal levels.https://gh.bmj.com/content/5/11/e003421.full |
| spellingShingle | Fei Yan Ying Wang Yun Chen Fan Li Na Wang Yi-Na Zhang Michelle Pender Xiao-Hua Ying Sheng-Lan Tang Chao-Wei Fu Reduction in healthcare services during the COVID-19 pandemic in China BMJ Global Health |
| title | Reduction in healthcare services during the COVID-19 pandemic in China |
| title_full | Reduction in healthcare services during the COVID-19 pandemic in China |
| title_fullStr | Reduction in healthcare services during the COVID-19 pandemic in China |
| title_full_unstemmed | Reduction in healthcare services during the COVID-19 pandemic in China |
| title_short | Reduction in healthcare services during the COVID-19 pandemic in China |
| title_sort | reduction in healthcare services during the covid 19 pandemic in china |
| url | https://gh.bmj.com/content/5/11/e003421.full |
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