دورية أكاديمية
أعرض في EDS

Associations between the stringency of COVID-19 containment policies and health service disruptions in 10 countries.

التفاصيل البيبلوغرافية
العنوان: Associations between the stringency of COVID-19 containment policies and health service disruptions in 10 countries.
المؤلفون: Reddy T; Biostatistics Research Unit, South African Medical Research Council, Durban, South Africa.; School of Mathematics, Statistics and Computer Science, University of KwaZulu Natal, Durban, South Africa., Kapoor NR; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA., Kubota S; World Health Organization, Vientiane, Lao People's Democratic Republic, Vientiane, Laos., Doubova SV; Epidemiology and Health Services Research Unit CMN Siglo XXI, Mexican Institute of Social Security, Mexico City, Mexico., Asai D; World Health Organization, Vientiane, Lao People's Democratic Republic, Vientiane, Laos., Mariam DH; School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia., Ayele W; School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia., Mebratie AD; School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia., Thermidor R; Studies and Planning Unit, Ministry of Public Health and Population, Port-Au-Prince, Haiti., Sapag JC; Public Health Department, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile., Bedregal P; Public Health Department, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile., Passi-Solar Á; Public Health Department, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile., Gordon-Strachan G; Caribbean Institute for Health Research, University of West Indies, Kingston, Jamaica., Dulal M; Office of the Member of Federal Parliament Gagan Kumar Thapa, Kathmandu, Nepal., Gadeka DD; School of Public Health, University of Ghana, Accra, Ghana., Mehata S; Ministry of Health, Koshi Province, Biratnagar, Nepal., Margozzini P; Public Health Department, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile., Leerapan B; Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand., Rittiphairoj T; Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand., Kaewkamjornchai P; Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand., Nega A; School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia., Awoonor-Williams JK; School of Public Health, University of Ghana, Accra, Ghana., Kruk ME; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA., Arsenault C; Department of Global Health, The George Washington University Milken Institute School of Public Health, Washington, USA. catherine.arsenault@gwu.edu.
المصدر: BMC health services research [BMC Health Serv Res] 2023 Apr 12; Vol. 23 (1), pp. 363. Date of Electronic Publication: 2023 Apr 12.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2001-
مواضيع طبية MeSH: Pandemics*/prevention & control , COVID-19*/epidemiology , COVID-19*/prevention & control, Humans ; Health Services ; Health Facilities ; Long-Term Care
مستخلص: Background: Disruptions in essential health services during the COVID-19 pandemic have been reported in several countries. Yet, patterns in health service disruption according to country responses remain unclear. In this paper, we investigate associations between the stringency of COVID-19 containment policies and disruptions in 31 health services in 10 low- middle- and high-income countries in 2020.
Methods: Using routine health information systems and administrative data from 10 countries (Chile, Ethiopia, Ghana, Haiti, Lao People's Democratic Republic, Mexico, Nepal, South Africa, South Korea, and Thailand) we estimated health service disruptions for the period of April to December 2020 by dividing monthly service provision at national levels by the average service provision in the 15 months pre-COVID (January 2019-March 2020). We used the Oxford COVID-19 Government Response Tracker (OxCGRT) index and multi-level linear regression analyses to assess associations between the stringency of restrictions and health service disruptions over nine months. We extended the analysis by examining associations between 11 individual containment or closure policies and health service disruptions. Models were adjusted for COVID caseload, health service category and country GDP and included robust standard errors.
Findings: Chronic disease care was among the most affected services. Regression analyses revealed that a 10% increase in the mean stringency index was associated with a 3.3 percentage-point (95% CI -3.9, -2.7) reduction in relative service volumes. Among individual policies, curfews, and the presence of a state of emergency, had the largest coefficients and were associated with 14.1 (95% CI -19.6, 8.7) and 10.7 (95% CI -12.7, -8.7) percentage-point lower relative service volumes, respectively. In contrast, number of COVID-19 cases in 2020 was not associated with health service disruptions in any model.
Conclusions: Although containment policies were crucial in reducing COVID-19 mortality in many contexts, it is important to consider the indirect effects of these restrictions. Strategies to improve the resilience of health systems should be designed to ensure that populations can continue accessing essential health care despite the presence of containment policies during future infectious disease outbreaks.
(© 2023. The Author(s).)
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معلومات مُعتمدة: 001 International WHO_ World Health Organization; INV-017293 United States GATES Bill & Melinda Gates Foundation; INV-005254 United States GATES Bill & Melinda Gates Foundation
فهرسة مساهمة: Keywords: COVID-19 restrictions; Health care disruptions; Health services; Health system resilience; Health systems; Pandemic response
تواريخ الأحداث: Date Created: 20230412 Date Completed: 20230414 Latest Revision: 20230903
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC10096103
DOI: 10.1186/s12913-023-09363-1
PMID: 37046260
قاعدة البيانات: MEDLINE
الوصف
تدمد:1472-6963
DOI:10.1186/s12913-023-09363-1