Abstract
Pandemics have wide-reaching effects on health service utilisation and diagnostic activity. Health service usage declined markedly during the COVID-19 pandemic across most diagnosis classes, especially those unrelated to the pandemic directly. These changes may potentially introduce pressure on the healthcare system in the future. This thesis analyses how the Finnish private healthcare service utilisation, diagnostic activity, and booking patterns were affected between January 2020 and June 2022 during the COVID-19 pandemic.
The study had access to a novel, comprehensive dataset on weekly Finnish private healthcare usage collected from routine electronic medical record data spanning the wide range of health service usage and diagnostic activity. Data from before the COVID-19 pandemic enabled us to create an estimate on the health service utilisation in the hypothetical case without the effect of the pandemic, which was compared to observed time series data. Of the three manuscripts that make up this thesis, one studied nationwide service utilisation, while two focused on the capital region of Uusimaa. The manuscripts covered data from 833 444, 632 466 and 900 572 patients, respectively.
We estimated that service utilisation rates for private healthcare usage decreased by one-fourth across different diagnosis classes during the early pandemic. Only some diagnosis classes recovered to pre-pandemic utilisation levels towards the end of the observation period, while some remained at permanently reduced levels. Upper respiratory system-related diseases displayed a notable increase in diagnostic activity during the initial weeks of the pandemic, as well as late in the observation period. We postulate that the decrease in service utilisation was driven by a decrease in service demand, to which supply reacted. Cancellations were a contributing factor to this decrease only during the first weeks of the pandemic, after which disengagement from within the services was passive. Digital services offered a rapidly scaleable service channel to regulate access to healthcare services. We highlight the importance of healthcare providers and policymakers collecting and utilising high-quality, up-to-date data when managing systemic healthcare utilisation shocks such as pandemics.
Translated title of the contribution | Muutokset yksityisen terveydenhuollon tarjonnassa, kysynnässä ja palveluiden käytössä COVID-19-pandemian aikana |
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Original language | English |
Qualification | Doctor's degree |
Awarding Institution |
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Supervisors/Advisors |
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Publisher | |
Print ISBNs | 978-952-64-1958-9 |
Electronic ISBNs | 978-952-64-1959-6 |
Publication status | Published - 2024 |
MoE publication type | G5 Doctoral dissertation (article) |
Keywords
- COVID-19
- Cov-SARS-2
- health service utilisation
- infection epidemiology
- health policy
- digital health