ArticleThe Lancet regional health. Western Pacific2021
The impact of the COVID-19 pandemic on health services utilization in China: Time-series analyses for 2016-2020.
Article in The Lancet regional health. Western Pacific, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 115 papers, 3 of them syntheses that pooled it.
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Who cites it
115 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Non-pharmaceutical interventions for COVID-19 reduced the incidence of infectious diseases: a controlled interrupted time-series study.Infectious diseases of poverty · 2023Pooled it
- Global burden of the COVID-19 associated patient-related delay in emergency healthcare: a panel of systematic review and meta-analyses.Globalization and health · 2022Pooled it
- Routine Health Information Systems in the European Context: A Systematic Review of Systematic Reviews.International journal of environmental research and public health · 2021Pooled it
- Out-of-Hospital Cardiac Arrest Before, During, and After the Pandemic of COVID-19.Journal of clinical medicine · 2026Article
- Health care utilization before and after COVID-19 diagnosis: a multidisease matched-cohort study by sociodemographic factors.BMC health services research · 2026Article
- Trends in incidence and DALYs of infectious disease from 2000 to 2023 and the attributable risk factors in China: an analysis of the Global Burden of Disease Study 2023.The Lancet regional health. Western Pacific · 2026Article
- Role of diagnostic testing in reducing unnecessary antibiotic use for upper respiratory tract infections in Chinese primary healthcare: a mixed-methods study.BMC primary care · 2026Article
- Comparison of the Burden of Acne Vulgaris in China vs Globally: Insights from the Global Burden of Disease Study (2021) and Projections to 2050.Acta dermato-venereologica · 2026Article
- Burden of herpes zoster and postherpetic neuralgia in Jinan, China: incidence, recurrence, and direct medical costs, 2018-2023, a population-based retrospective cohort study.BMC infectious diseases · 2026Article
- The epidemic and socioeconomic factors shock: a long-term dynamic analysis of equity in infectious disease healthcare in China.International journal for equity in health · 2026Article
- Policy stringency during the COVID-19 pandemic and healthcare services utilization in China: An interrupted time-series analysis.PLoS medicine · 2026Article
- Trends in drug use and prescription patterns for Crohn's disease patients in China, 2018-2022.BMC health services research · 2026Article
- Impact of government subsidy reforms on primary health care efficiency in rural eastern China: an interrupted time series analysis.BMC health services research · 2026Article
- Smoking-attributable low-back pain disability in China versus high income countries among adults aged 20-54 years, 1990-2023: A secondary dataset analysis of GBD 2023.Tobacco induced diseases · 2026Article
- Characteristics of rare diseases cases: A summary analysis of hospitalized patients at a hospital in Western China from 2015 to 2023.Intractable & rare diseases research · 2025Article
- Physician agency in China: evidence from physicians' responses to financial pressure during the COVID-19 pandemic.Health economics review · 2025Article
- Spatiotemporal evolution and determinants analysis of health resource supply-demand coupling coordination in China.International journal for equity in health · 2025Article
- Indirect Impact of the COVID-19 Pandemic on All-Cause Mortality and Cardiovascular Disease Among People With Diabetes Mellitus From Korea and Hong Kong: An Interrupted Time Series Analysis.Health science reports · 2025Article
- Impact of COVID-19 pandemic, and the mediating role of hospital caseload and severity on mortality of hospitalised tuberculosis patients in Thailand.Global health research and policy · 2025Article
- Prescription Trends for Primary Headache in Children and Adolescents in China During 2019-2023: A Retrospective Study.Paediatric drugs · 2025Article
55 more citing papers are in PubMed but not listed here.
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Authors and funding
7 authors.
Funding
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Abstract
backgroundThe aim of this study is to quantify the effects of the SARS-CoV-2 pandemic on health services utilization in China using over four years of routine health information system data.
methodsWe conducted a retrospective observational cohort study of health services utilization from health facilities at all levels in all provinces of mainland China. We analyzed monthly all-cause health facility visits and inpatient volume in health facilities before and during the SARS-CoV-2 outbreak using nationwide routine health information system data from January 2016 to June 2020. We used interrupted time series analyses and segmented negative binomial regression to examine changes in healthcare utilization attributable to the pandemic. Stratified analyses by facility type and by provincial Human Development Index (HDI) - an area-level measure of socioeconomic status - were conducted to assess potential heterogeneity in effects.
findingsIn the months before the SARS-CoV-2 outbreak, a positive secular trend in patterns of healthcare utilization was observed. After the SARS-CoV-2 outbreak, we noted statistically significant decreases in all indicators, with all indicators achieving their nadir in February 2020. The magnitude of decline in February ranged from 63% (95% CI 61-65%;
interpretationInpatient and outpatient health services utilization in China declined significantly after the SARS-CoV-2 outbreak, likely due to changes in patient and provider behaviors, suspension of health facilities or their non-emergency services, massive mobility restrictions, and the potential reduction in the risk of non-SARS-COV-2 diseases. All indicators rebounded beginning in March but most had not recovered to their pre-SARS-COV-2 levels as of June 2020.
fundingThe National Natural Science Foundation of China (No. 72042014).
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