How did the Pandemic Affect Health Utilization for Non-COVID-19 People? Mixed Methods Study in Primary and Tertiary Care from Ankara, Turkey?

Abstract

Aim: We aim to determine the effect of the pandemic on the characteristics of health utilization of non-COVID 19 people.

Method: Quantitative research was conducted on those who applied to two family health centers (n=200) and Gazi Hospital (n=210) in Ankara. Qualitative research was conducted on health workers or managers from primary care (PC) and tertiary care (TC) (Gazi and Gülhane hospital) and consultants of the Ministry of Health. We also used the health records of Gazi hospital.

Results: Making an appointment is the most common problem faced by people applying for both PC (19,0%) and TC (32,9%) during the pandemic. The follow-up percentages for PC and TC during the pandemic were 60%-56.3% in DM, 54.2%-54.9% in hypertension, 28.6%-46.2% in COPD, and 16.7%-48.5% in mental health problems, respectively. For all diseases investigated, these percentages were above 80% before the pandemic. During the pandemic period, a sharp decrease between 5% and 85% was observed in outpatients and inpatients due to DM, HT and COPD in Gazi hospital. Participants of the qualitative study stated that delayed admission to the health institution causes more complicated case diagnoses. According to health workers, the groups most affected by the lack of access to healthcare services are demographic group elderly patients and medical group cancer patients. It was emphasized that PC plays an important role in the continuity of health services.

Conclusion: In the short term, it may be suggested to develop informative materials about conditions that require urgent treatment and follow-up processes of non-communicable diseases (NCDs) during the pandemic.Interruptions in NCDs follow-up and treatment may create the potential for increased morbidity and mortality. Countries should make their plans considering the long-term effects of pandemic on the health system. The pandemic has revealed the importance of PC for accessible and sustainable health care.