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Original article Changes in mental health service utilization before and during the COVID-19 pandemic: a nationwide database analysis in Korea
Kyoung Hoon Kim1orcid , Sang Min Lee2orcid , Minha Hong3orcid , Kyu-Man Han4orcid , Jong-Woo Paik2orcid
Epidemiol Health 2022;e2023022
DOI: https://doi.org/10.4178/epih.e2023022 [Accepted]
Published online: February 14, 2023
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1Health Insurance Review and Assessment Service, Wonju, Korea
2Department of Psychiatry, College of Medicine, Kyung Hee University Hospital, Kyung Hee University, Seoul, Republic of Korea, Seoul, Korea
3Department of Psychiatry, Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea , Goyang, Korea
4Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea, Republic of Korea, Seoul, Korea
Corresponding author:  Jong-Woo Paik,
Email: paikjw@khu.ac.kr
Received: 20 August 2022   • Revised: 15 January 2023   • Accepted: 25 January 2023
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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.

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