ArticleBMC health services research2026
Changes in usual source of care utilization during the COVID-19 pandemic: a comparative analysis by chronic disease status.
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe coronavirus disease 2019 (COVID-19) pandemic substantially disrupted healthcare systems worldwide, leading to marked declines in outpatient visits and essential services, particularly among patients with chronic conditions and older adults. South Korea experienced similar reductions in outpatient utilization during the early pandemic period, raising concerns about unmet healthcare needs and continuity of care. These disruptions highlighted the vulnerability of populations requiring regular medical management and underscored the importance of examining utilization patterns across different patient groups and usual sources of care.
methodsOutpatient visit data were drawn from the Korean Health Panel (KHPS) for the period from January 1, 2019, to December 31, 2020. An interrupted time series analysis (ITSA) was performed, with stratification by presence of chronic conditions (non-chronic vs. chronic) and age (under 65 vs. 65 and older). Utilization was further analyzed by USC type: clinics, hospitals, and general hospitals.
resultsImmediately following the first COVID-19 intervention, outpatient visits to clinics declined among individuals under 65 in the non-chronic group and among both age subgroups in the chronic disease group, with utilization rebounding in all three subgroups after the second intervention. In contrast, visits to hospitals and general hospitals increased. When not stratified by USC type, overall outpatient utilization increased in the non-chronic group but decreased among older adults with chronic diseases.
conclusionThe COVID-19 pandemic affected outpatient healthcare utilization in varied ways depending on age, health status, and USC type. The notable decline in clinic visits among older adults with chronic conditions indicates reduced access to primary care during the pandemic. These findings highlight the need for healthcare policies that safeguard continuity of care for vulnerable populations and prioritize primary care during public health emergencies.
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