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COVID-19: Original Article
Changes in mental health service utilization before and during the COVID-19 pandemic: a nationwide database analysis in Korea
Kyoung Hoon Kim, Sang Min Lee, Minha Hong, Kyu-Man Han, Jong-Woo Paik
Epidemiol Health. 2023;45:e2023022.   Published online February 14, 2023
DOI: https://doi.org/10.4178/epih.e2023022
  • 5,772 View
  • 271 Download
  • 3 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The present study examined the impact of the coronavirus disease 2019 (COVID-19) pandemic on mental health service utilization through a comparative analysis of nationwide data regarding inpatient care users, outpatient visits, emergency department (ED) visits, and admissions via the ED before and during the pandemic.
METHODS
Data from approximately 350,000 Koreans diagnosed with mental illness were analyzed in terms of hospitalization, outpatient visits, and ED visits between January 2018 and June 2021. An interrupted time series analysis was conducted to determine the significance of changes in mental health service utilization indicators.
RESULTS
The number of hospital admissions per patient decreased by 1.2% at the start of the pandemic and 0.7% afterward. The length of hospital stay increased by 1.8% at the outbreak of the pandemic, and then decreased by 20.2%. Although the number of outpatients increased, the number of outpatient visits per patient decreased; the number of outpatient visits for schizophrenia (3.4%) and bipolar disorder (3.5%) significantly decreased immediately post-outbreak. The number of ED visits per patient decreased both immediately post-outbreak and afterward, and ED visits for schizophrenia (19.2%), bipolar disorder (22.3%), and depression (17.4%) decreased significantly immediately post-outbreak. Admissions via the ED did not show a significant change immediately post-outbreak.
CONCLUSIONS
Mental health service utilization increased during the pandemic, but medical service use decreased overall, with a particularly significant decrease in ED utilization. As the pandemic worsened, the decline in outpatient visits became more pronounced among those with severe mental illness.
Summary
Korean summary
이 연구는 COVID-19 전후 정신질환 의료서비스 이용 변화를 분석하였다. 팬데믹 기간 중에 정신질환 의료서비스는 전반적으로 감소하였고, 특히 중증 정신질환의 외래 방문이 감소하였다. 따라서, 정신질환자의 진료 연속성을 보장하기 위한 조치가 요구된다.
Key Message
This study examined the impact of the COVID-19 pandemic on mental health service utilization. The mental health service utilization decreased overall after the outbreak of COVID-19, especially outpatient visits for severe mental illness significantly decreased. Therefore, countermeasures are needed to maintain the continuity of care.

Citations

Citations to this article as recorded by  
  • Adult Mental Health Presentations to Emergency Departments in Victoria, Australia between January 2018 and October 2020: Changes Associated with COVID-19 Pandemic Public Health Restrictions
    Jackson Newberry-Dupé, Wanyu Chu, Simon Craig, Rohan Borschmann, Gerard O’Reilly, Paul Yates, Glenn Melvin, Kylie King, Harriet Hiscock
    Psychiatric Quarterly.2023;[Epub]     CrossRef
Original Articles
Factors associated with seeking treatment for postpartum morbidities in rural India
Aditya Singh, Abhishek Kumar
Epidemiol Health. 2014;36:e2014026.   Published online October 30, 2014
DOI: https://doi.org/10.4178/epih/e2014026
  • 17,191 View
  • 167 Download
  • 5 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
To understand the prevalence of postpartum morbidities and factors associated with treatment-seeking behaviour among currently married women aged 15-49 residing in rural India.
METHODS
We used data from the nationally representative District Level Household Survey from 2007-2008. Cross-tabulation was used to understand the differentials for the prevalence of postpartum morbidities and treatment-seeking behaviours across selected background characteristics. Two-level binary logistic regression was applied to understand the factors associated with treatment-seeking behaviour.
RESULTS
Approximately 39.8% of rural women suffered from at least one of the six postpartum morbidities including high fever, lower abdominal pain, foul-smelling vaginal discharge, excessive bleeding, convulsions, and severe headache. Morbidities were more prevalent among poor, illiterate, Muslim, and high-parity women. About 55.1% of these rural women sought treatment/consultation for their problems. The odds of seeking treatment/consultation increased as economic status and years of schooling among both the woman and her husband increased. Poor, uneducated, unemployed, Hindu, and tribal women were less likely to seek treatment/consultation for postpartum morbidities than their counterparts were. The odds of seeking treatment/consultation decreased as the distance to the nearest private health facility increased. Most women visited a private hospital (46.3%) or a friend/family member’s home (20.8%) for treatment/consultation. Only a small percentage visited publicly funded health institutions such as a primary health centre (8.8%), community health centre (6.5%), health sub-centre (2.8%), or district hospital (13.1%). Rural women from the northeast region of India were 50% less likely to seek treatment/consultation than women from the central region were.
CONCLUSIONS
Providing antenatal and delivery care, and ensuring nearby government healthcare facilities are available to serve rural women might increase the likelihood of care-seeking for postpartum morbidities. Targeted interventions for vulnerable groups should be considered in future policies to increase the likelihood women will seek treatment or advice postpartum.
Summary

Citations

Citations to this article as recorded by  
  • Assessing the Utilization of Postnatal Services Among Mothers: A Cross-Sectional Study
    Sunvir Kaur Rai, Simmi Oberoi, Rajinder Singh Balgir, Dharminder Ahir, Harpreet Singh
    Cureus.2023;[Epub]     CrossRef
  • Incidence of postpartum and neonatal illnesses and utilization of healthcare services in rural communities in southern Ethiopia: A prospective cohort study
    Moges Tadesse Borde, Eskindir Loha, Bernt Lindtjørn, Diane Farrar
    PLOS ONE.2020; 15(8): e0237852.     CrossRef
  • Determinants of primary healthcare seeking behaviours for children during the first 18 months of life in Benin
    A Brembilla, J -F Faucher, A Garcia, K G Koura, P Deloron, A -L Parmentier, C Pierrat, G Cottrell, F Mauny
    International Health.2018; 10(4): 237.     CrossRef
  • Postpartum morbidities in Iranian women 5 years after childbirth: A longitudinal study
    Maryam Rouhi, Maryam Vizheh, Leila Rouhi, Hossein Esmaili, Leila Vaziri, Zeynab Fathi Gherekhlou
    British Journal of Midwifery.2016; 24(4): 268.     CrossRef
Co-prescribing Patterns of Contraindicated Drugs for the Elderly Patients in Busan.
Nam Kyong Choi, Sun Young Jung, Byung Joo Park
Korean J Epidemiol. 2008;30(1):128-136.   Published online June 30, 2008
DOI: https://doi.org/10.4178/kje.2008.30.1.128
  • 65,535 View
  • 28 Download
AbstractAbstract PDF
Abstract
PURPOSE
To estimate the prevalence of co-prescribing contraindicated drugs for elderly patients in Busan.
METHODS
We used the Health Insurance Review Agency (HIRA) claims database. Study population consisted of elderly patients who visited clinics or hospitals in Busan metropolitan city from January 1, 2000 to December 31, 2001. Contraindicated drugs were defined as 162 combinations of contraindicated drugs announced by the Korea Ministry of Health and Welfare in 2004. The co-prescription of contraindicated drugs was defined as prescribing two or more contraindicated drugs in combination in the same prescription. The prevalence of co-prescribing contraindicated drugswas estimated as proportion of co-prescribed patients out of the study patients. We estimated and age-adjusted prevalence and its 95% confidence interval of co-prescription of contraindicated drugs among the elderly patients in Korean population in 2001.
RESULTS
The study elderly patients were 262,952 with 2,483,227 prescriptions. Among the study patients 1,208 (4.6%) were prescribed contraindicated drugs in combination. A total of 16,255 patients were estimated as the number of co-prescribed patients among the Korean elderly in 2001. Age-standardized prevalence of co-prescription to the Korean elderly was estimated to be 45 per 10,000 persons. The most frequently prescribed combinations were cisapride & amitriptyline, roxithromycin & ergoloid mesylate, and terfenadine & erythromycin, and the frequency were 325 (16.8%), 149 (7.7%), and 132 (6.8%),respectively.
CONCLUSIONS
The contraindicated drugs were co-prescribed to the elderly patients in Korea. Many of these co-prescriptions should be avoided if unnecessary. The patients should be carefully monitored if they were inevitably prescribed the contraindicated drugs.
Summary

Epidemiol Health : Epidemiology and Health