Health Service Utilization in Hong Kong During the COVID-19 Pandemic – A Cross-sectional Public Survey

• Published in: International journal of health policy and management Vol. 11; no. 4; pp. 508 - 513
• Main Authors: Hung, Kevin KC, Walline, Joseph H., Chan, Emily Ying Yang, Huang, Zhe, Lo, Eugene Siu Kai, Yeoh, Eng Kiong, Graham, Colin A.
• Format: Journal Article
• Language: English
• Published: Iran Kerman University of Medical Sciences 01.04.2022
• Subjects: access to healthcare; Adult; Coronaviruses; COVID-19; COVID-19 - epidemiology; COVID-19 - therapy; Cross-Sectional Studies; Epidemics; fear of infection; Female; Health care industry; Health policy; health seeking behavior; Health Services; Health services utilization; Hong Kong - epidemiology; Humans; Male; Medical care; Medical care utilization; Medical policy; Original; Pandemics; Preventable deaths; Questionnaires; Surveys; Utilization; Hong Kong; Hong Kong China; China; Fear of Infection; Access to Healthcare; Health Seeking Behavior
• ISSN: 2322-5939; 2322-5939
• DOI: 10.34172/ijhpm.2020.183

Background: As health systems across the world respond to the coronavirus disease 2019 (COVID-19), there is rising concern that patients without COVID-19 are not receiving timely emergency care, resulting in avoidable deaths. This study examined patterns of self-reported health service utilization, their socio-demographic determinants and association with avoidable deaths during the COVID-19 outbreak. Methods: A cross-sectional telephone survey was conducted between March 22 and April 1, 2020, during the peak rise in confirmed COVID-19 cases in Hong Kong. Cantonese-speaking Hong Kong residents over 18-years-old were recruited using a computerised random digital dialling (RDD) system. The RDD method used stratified random sampling to ensure a representative sample of the target population by age, gender, and residential district. A structured self-reported questionnaire was used. Results: Out of 1738 placed calls, 765 subjects responded to the questionnaire (44.0% response rate). The factors associated with avoiding medical consultation included being female (37.2% vs. 22.5%, P <.001), married (32.8% vs. 27%, P =.044), completing tertiary education (35.3% vs. 27.7% (secondary) vs. 14.8% (primary), P =.005), and those who reported a "large/very large" impact of COVID-19 on their mental health (36.1% vs 30.5% (neutral) vs. 19.7% (very small/small), P =.047) using logistic regression analysis. Conclusion: Married females with both higher educational attainment and concern about COVID-19 were associated with avoiding healthcare services. Timely public communication to encourage and promote early health seeking treatment even during extreme events such as pandemics are needed.