Impact of COVID-19 pandemic on utilisation of healthcare services: a systematic review.

摘要: Objectives To determine the extent and nature of changes in utilisation healthcare services during COVID-19 pandemic. Design Systematic review. Eligibility Eligible studies compared pandemic to at least one comparable period prior years. Services included visits, admissions, diagnostics therapeutics. Studies were excluded if from single centres or studied only patients with COVID-19. Data sources PubMed, Embase, Cochrane Study Register preprints searched, without language restrictions, until 10 August, using detailed searches key concepts including COVID-19, health impact. analysis Risk bias was assessed by adapting Bias Non-randomised Interventions tool, a Effective Practice Organization Care tool. Results analysed descriptive statistics, graphical figures narrative synthesis. Outcome measures Primary outcome change service between prepandemic periods. Secondary proportions users milder more severe illness (eg, triage scores). 3097 unique references identified, 81 across 20 countries included, reporting on >11 million 6.9 million For primary outcome, there 143 estimates changes, median 37% reduction overall (IQR −51% −20%), comprising reductions for visits 42% (−53% −32%), admissions 28% (−40% −17%), 31% −24%) therapeutics 30% (−57% −19%). Among 35 secondary outcomes, 60 estimates, 27 (45%) larger among people spectrum illness, 33 (55%) no difference. Conclusions Healthcare decreased about third pandemic, considerable variation, greater less illness. While addressing unmet need remains priority, impacts may help systems reduce unnecessary care postpandemic recovery. PROSPERO registration number CRD42020203729.