Changes in private healthcare supply, demand, and service utilisation during the COVID-19 pandemic

Oskar Niemenoja

Changes in private healthcare supply, demand, and service utilisation during the COVID-19 pandemic

Julkaisun otsikon käännös: Muutokset yksityisen terveydenhuollon tarjonnassa, kysynnässä ja palveluiden käytössä COVID-19-pandemian aikana

Oskar Niemenoja

Tuotantotalouden laitos

Tutkimustuotos: Doctoral Thesis › Collection of Articles

Abstrakti

Pandemioilla on laaja-alainen vaikutus terveyspalveluiden käyttöön ja kysyntäkäyttäytymiseen. Terveyspalveluiden käyttö laski merkittävästi COVID-19 -pandemian aikana useimmissa diagnoosiluokissa, erityisesti sellaisissa jotka eivät suoraan liity pandemiaan. Tämä terveyspalveluiden käytön lasku voi aiheuttaa pitkäaikaista rasitusta terveydenhuoltojärjestelmälle pandemian aikana ja sen jälkeen. Tämä väitöskirja analyisoi miten yksityisten terveydenhuollon palveluiden käyttö, tautien diagnosointi sekä ajanvarausten dynamiikka käyttäytyivät Suomessa tammikuun 2020 ja kesäkuun 2022 välillä COVID-19 -pandemian aikana. Tällä tutkimuksella oli pääsy aiemmin julkaisemattomaan ja kattavaan aineistoon suomalaisesta yksityisestä terveydenhuollon käytöstä. Aineisto koostui viikkotasoisesta terveydenhuollon käytön rekisteriaineistosta, joka kattoi laajasti eri diagnoosiluokat sekä terveyspalveluiden käytön. Aineisto ulottui myös pandemiaa edeltävälle ajalle, joka mahdollisti uskottavan ennustemallin luomisen palvelukulutuksesta hypoteettisessa tilanteessa, jossa koronapandemiaa ei olisi tapahtunut. Tätä ennustetta verrattiin palveluiden toteutuneeseen käyttöön. Tämä väitöskirja koostuu kolmesta osatutkimuksesta, joista yksi tutki palvelukäytön muutosta kansallisesti, kun taas kaksi muuta rajautuivat alueellisesti tarkastelemaan Uusimaan aluetta. Tutkimusten otannat olivat 833 444, 632 466 ja 900 572 potilasta. Arviomme mukaan yksityisten terveyspalveluiden käyttö laski keskimäärin neljänneksellä pandemian alkuvaiheen aikana. Vain osa diagnoosiryhmien palvelukäytöstä palautui tarkastelujakson aikana ennustetulle tasolle, kun taas useat jäivät tarkastelujaksolla pysyvästi oletettua alemmalle tasolle. Ylähengitystietaudeissa tapahtui merkittävää palvelukäytön kasvua välittömästi pandemian alussa sekä tarkastelujakson lopussa. Esitämme, että tämä palvelukäytön lasku oli kysyntävetoista, ja tarjonta reagoi tähän kysynnän laskuun. Peruutuksien vaikutus palvelukäytön laskuun oli merkittävä vain pandemian alussa, jonka jälkeen poistuminen terveyspalveluiden piiristä tapahtui passiivisesti. Digitaaliset palvelut tarjosivat pandemian aikana nopeasti mukautuvan palvelukanavan, joka tasoitti pääsyä terveyspalveluiden piiriin. Korostamme korkealuokkaisen ja ajantasaisen tiedon keräämisen ja hyödyntämisen merkitystä terveydenhuollon tarjoajille sekä päättäjille terveydenhuollon shokkien hallinnassa.

Julkaisun otsikon käännös	Muutokset yksityisen terveydenhuollon tarjonnassa, kysynnässä ja palveluiden käytössä COVID-19-pandemian aikana
Alkuperäiskieli	Englanti
Pätevyys	Tohtorintutkinto
Myöntävä instituutio	Aalto-yliopisto
Valvoja/neuvonantaja	Saarinen, Lauri, Vastuuprofessori Lillrank, Paul, Ohjaaja Taimela, Simo, Ohjaaja, Ulkoinen henkilö Bono, Petri, Ohjaaja, Ulkoinen henkilö
Kustantaja	Aalto University
Painoksen ISBN	978-952-64-1958-9
Sähköinen ISBN	978-952-64-1959-6
Tila	Julkaistu - 2024
OKM-julkaisutyyppi	G5 Artikkeliväitöskirja

Tutkimusalat

COVID-19
Cov-SARS-2
terveyspalveluiden käyttö
infektioepidemologia
terveyspolitiikka
digitaalinen terveydenhuolto

YK:n kestävän kehityksen tavoitteet

Tämä tuotos edistää seuraavia kestävän kehityksen tavoitteita:

Pääsy asiakirjaan

http://urn.fi/URN:ISBN:978-952-64-1959-6

Siteeraa tätä

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title = "Changes in private healthcare supply, demand, and service utilisation during the COVID-19 pandemic",

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.",

keywords = "COVID-19, Cov-SARS-2, health service utilisation, infection epidemiology, health policy, digital health, COVID-19, Cov-SARS-2, terveyspalveluiden k{\"a}ytt{\"o}, infektioepidemologia, terveyspolitiikka, digitaalinen terveydenhuolto, COVID-19, Cov-SARS-2, health service utilisation, infection epidemiology, health policy, digital health",

author = "Oskar Niemenoja",

year = "2024",

language = "English",

isbn = "978-952-64-1958-9",

series = "Aalto University publication series DOCTORAL THESES",

publisher = "Aalto University",

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TY - BOOK

T1 - Changes in private healthcare supply, demand, and service utilisation during the COVID-19 pandemic

AU - Niemenoja, Oskar

PY - 2024

Y1 - 2024

N2 - 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.

AB - 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.

KW - COVID-19

KW - Cov-SARS-2

KW - health service utilisation

KW - infection epidemiology

KW - health policy

KW - digital health

KW - COVID-19

KW - Cov-SARS-2

KW - terveyspalveluiden käyttö

KW - infektioepidemologia

KW - terveyspolitiikka

KW - digitaalinen terveydenhuolto

KW - COVID-19

KW - Cov-SARS-2

KW - health service utilisation

KW - infection epidemiology

KW - health policy

KW - digital health

M3 - Doctoral Thesis

SN - 978-952-64-1958-9

T3 - Aalto University publication series DOCTORAL THESES

PB - Aalto University

ER -

Changes in private healthcare supply, demand, and service utilisation during the COVID-19 pandemic

Abstrakti

Tutkimusalat

YK:n kestävän kehityksen tavoitteet

Pääsy asiakirjaan

Sormenjälki

Siteeraa tätä