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      Analysis of health service utilization and influencing factors due to COVID-19 in Beijing: a large cross-sectional survey

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          Abstract

          Background

          In the wake of China’s relaxed zero-COVID policy, there was a surge in coronavirus disease 2019 (COVID-19) infections. This study aimed to examine the infection status and health service utilization among Beijing residents during a widespread outbreak, and to explore the factors that affected utilization of health services due to COVID-19.

          Methods

          A cross-sectional survey was conducted among Beijing residents from 13 January to 13 February 2023, collecting information on socio-demographic characteristics, health behaviours, COVID-19 infection status, utilization of health services and depressive symptoms. Multivariate Tobit regression was used for data analysis.

          Results

          Among the 53 924 participants, 14.7% were older than 60 years, 63.7% were female and 84.8% were married. In total, 44 992 of the 53 924 individuals surveyed (83.4%) contracted COVID-19 during 2020–2023, and 25.2% (13 587) sought corresponding health services. The majority of individuals (85.6%) chose in-person healthcare, while 14.4% chose internet-based healthcare. Among those who chose in-person healthcare, 58.6% preferred primary healthcare institutions and 41.5% were very satisfied with the treatment. Factors affecting health service utilization include being female ( β = −0.15, P < 0.001), older than 60 years ( β = 0.23, P < 0.01), non-healthcare workers ( β = −0.60, P < 0.001), rich self-rated income level ( β = 0.59, P < 0.001), having underlying disease ( β = 0.51, P < 0.001), living alone ( β = −0.19, P < 0.05), depressive symptoms ( β = 0.06, P < 0.001) and healthy lifestyle habits, as well as longer infection duration, higher infection numbers and severe symptoms.

          Conclusion

          As COVID-19 is becoming more frequent and less severe, providing safe and accessible healthcare remains critical. Vulnerable groups such as the elderly and those with underlying conditions need reliable health service. Prioritizing primary healthcare resources and online medical services have played a vital role in enhancing resource utilization efficiency.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12961-024-01118-6.

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          Most cited references28

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          Virtually Perfect? Telemedicine for Covid-19

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            Estimation of Relationships for Limited Dependent Variables

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              How mental health care should change as a consequence of the COVID-19 pandemic

              Summary The unpredictability and uncertainty of the COVID-19 pandemic; the associated lockdowns, physical distancing, and other containment strategies; and the resulting economic breakdown could increase the risk of mental health problems and exacerbate health inequalities. Preliminary findings suggest adverse mental health effects in previously healthy people and especially in people with pre-existing mental health disorders. Despite the heterogeneity of worldwide health systems, efforts have been made to adapt the delivery of mental health care to the demands of COVID-19. Mental health concerns have been addressed via the public mental health response and by adapting mental health services, mostly focusing on infection control, modifying access to diagnosis and treatment, ensuring continuity of care for mental health service users, and paying attention to new cases of mental ill health and populations at high risk of mental health problems. Sustainable adaptations of delivery systems for mental health care should be developed by experts, clinicians, and service users, and should be specifically designed to mitigate disparities in health-care provision. Thorough and continuous assessment of health and service-use outcomes in mental health clinical practice will be crucial for defining which practices should be further developed and which discontinued. For this Position Paper, an international group of clinicians, mental health experts, and users of mental health services has come together to reflect on the challenges for mental health that COVID-19 poses. The interconnectedness of the world made society vulnerable to this infection, but it also provides the infrastructure to address previous system failings by disseminating good practices that can result in sustained, efficient, and equitable delivery of mental health-care delivery. Thus, the COVID-19 pandemic could be an opportunity to improve mental health services.
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                Author and article information

                Contributors
                jing624218@163.com
                haoyt@bjmu.edu.cn
                lyang@bjmu.edu.cn
                Journal
                Health Res Policy Syst
                Health Res Policy Syst
                Health Research Policy and Systems
                BioMed Central (London )
                1478-4505
                4 March 2024
                4 March 2024
                2024
                : 22
                : 31
                Affiliations
                [1 ]GRID grid.11135.37, ISNI 0000 0001 2256 9319, Department of Health Policy and Management, , Peking University School of Public Health, ; 38 Xueyuan Road, Haidian District, Beijing, 100191 China
                [2 ]GRID grid.11135.37, ISNI 0000 0001 2256 9319, Department of Occupational and Environmental Health Sciences, , Peking University School of Public Health, ; 38 Xueyuan Road, Haidian District, Beijing, 100191 China
                [3 ]Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, ( https://ror.org/00a0jsq62) 15-17 Tavistock Place, London, WC1H 9SH United Kingdom
                [4 ]Brown School, Washington University in St. Louis, ( https://ror.org/01yc7t268) St. Louis, Missouri 63130 United States of America
                [5 ]General Practice Department, Second Outpatient Section, Peking University Third Hospital, ( https://ror.org/04wwqze12) Xisanqi Street, Haidian District, Beijing, 100096 China
                [6 ]Center for Public Health and Epidemic Preparedness and Response, Peking University, ( https://ror.org/02v51f717) 38 Xueyuan Road, Haidian District, Beijing, 100191 China
                Author information
                http://orcid.org/0009-0000-0866-2154
                http://orcid.org/0000-0003-0640-2003
                Article
                1118
                10.1186/s12961-024-01118-6
                10910832
                8a48fa99-3365-4be9-9105-9de3bec0e462
                © The Author(s) 2024

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 27 September 2023
                : 5 February 2024
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001809, National Natural Science Foundation of China;
                Award ID: 72174010
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100004826, Natural Science Foundation of Beijing Municipality;
                Award ID: M22033
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100010270, Capital Health Research and Development of Special Fund;
                Award ID: 2021-1G-4091
                Award Recipient :
                Categories
                Research
                Custom metadata
                © BioMed Central Ltd., part of Springer Nature 2024

                Health & Social care
                health service utilization,covid-19,primary healthcare services,internet-based healthcare

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