Osong Public Health and Research Perspectives

Original Article

The COVID-19 pandemic and healthcare utilization in Iran: evidence from an interrupted time series analysis: Monireh Mahmoodpour-Azari, Satar Rezaei, Nasim Badiee, Mohammad Hajizadeh, Ali Mohammadi, Ali Kazemi-Karyani, Shahin Soltani, Mehdi Khezeli; Osong Public Health Res Perspect. 2023;14(3):180-187. Published online June 22, 2023; DOI: https://doi.org/10.24171/j.phrp.2023.0041

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Objectives
This study aimed to examine the effect of the coronavirus disease 2019 (COVID-19) outbreak on the hospitalization rate, emergency department (ED) visits, and outpatient clinic visits in western Iran.
Methods
We collected data on the monthly hospitalization rate, rate of patients referred to the ED, and rate of patients referred to outpatient clinics for a period of 40 months (23 months before and 17 months after the COVID-19 outbreak in Iran) from all 7 public hospitals in the city of Kermanshah. An interrupted time series analysis was conducted to examine the impact of COVID-19 on the outcome variables in this study.
Results
A statistically significant decrease of 38.11 hospitalizations per 10,000 population (95% confidence interval [CI], 24.93–51.29) was observed in the first month of the COVID-19 outbreak. The corresponding reductions in ED visits and outpatient visits per 10,000 population were 191.65 (95% CI, 166.63–216.66) and 168.57 (95% CI, 126.41–210.73), respectively. After the initial reduction, significant monthly increases in the hospitalization rate (an increase of 1.81 per 10,000 population), ED visits (an increase of 2.16 per 10,000 population), and outpatient clinic visits (an increase of 5.77 per 10,000 population) were observed during the COVID-19 pandemic.
Conclusion
Our study showed that the utilization of outpatient and inpatient services in hospitals and clinics significantly declined after the COVID-19 outbreak, and use of these services did not return to pre-outbreak levels as of June 2021.

Citations

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Review Article

Social determinants of adherence to COVID-19 preventive guidelines: a comprehensive review: Zahra Jorjoran Shushtari, Yahya Salimi, Sina Ahmadi, Nader Rajabi-Gilan, Marzieh Shirazikhah, Akbar Biglarian, Ali Almasi, Mohammad Ali Mohammadi Gharehghani; Osong Public Health Res Perspect. 2021;12(6):346-360. Published online December 21, 2021; DOI: https://doi.org/10.24171/j.phrp.2021.0180

9,738 View
176 Download
24 Web of Science
27 Crossref

Graphical Abstract Abstract PDF Supplementary Material

Adherence to coronavirus disease 2019 (COVID-19) preventive guidelines (ACPG) is an important strategy to control the COVID-19 pandemic effectively. The present study aimed to identify and summarize the social determinants of ACPG among the general population. A comprehensive review was performed from December 2019 to February 2021 through searching electronic databases. Two independent reviewers assessed and selected relevant studies. Next, the characteristics and main findings of the included studies were summarized. Finally, the World Health Organization’s conceptual framework of social determinants of health was used to synthesize the identified social determinants of ACPG. Forty-one of 453 retrieved articles met the inclusion criteria. The study results showed different patterns of ACPG among various communities. Furthermore, 84 social determinants were identified and categorized into structural and intermediary determinants. ACPG is a set of complex behaviors associated with different individual sociodemographic and behavioral characteristics; living and working conditions; COVID-19 knowledge, attitudes, and risk perceptions; exposure to sources and information level; leisure activities; social support; trust; social norms; psychosocial well-being; socio-economic position; and the socio-economic and political context. Interventions to promote ACPG among the general population should consider the identified social determinants of ACPG.

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