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Research Article
Trends of Follow-Up Clinic Visits and Admissions Three-Months Before and During COVID-19 Pandemic at Tikur Anbessa Specialized Hospital, Ethiopia: an Interrupted Time Series Analysis
Workeabeba Abebe
Addis Ababa University
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Following the first report of the COVID-19 case in Ethiopia on the 13th of March 2020, the country adopted a lockdown policy to contain the spread of the virus. Responding to the health-care burden imposed by the COVID-19 pandemic had to be coupled with ensuring essential health care services. This study assessed the impact of COVID-19 on the trends of non-COVID follow-up visits and admissions at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
Methods: A retrospective, time-series study with the 1st case of COVID-19 report as a reference time examined the trend in follow-up visits and admissions between December 1st, 2019 and May 31st, 2020. A comparison of health care utilization between December 2019 to May 2020 and its equivalent period in 2018/19 was also done. A data abstraction tool was used to collect secondary data from the hospital’s electronic medical recordings and logbooks of each unit.
Results: A total of 7,717 visits from eight follow-up clinics and 3,310 admissions were collected during three months before the onset of COVID-19. During the following three months after the pandemic, 4,597 visits and 2,383 admissions were collected. Overall, a 40.4% decrease in follow-up visits and a 28% decline in admissions were observed during the COVID-19. The drop in the daily follow-up visits was observed for both genders. The number of visits in all follow-up clinics in 2019/2020 decreased when compared to the same months in 2018/19(p<0.05). Follow-up visits were substantially lower for renal patients (-68%), patients with neurologic problems (−53.9%), antiretroviral treatment clinics (−52.3%), cardiac patients (−51.4%). Although pediatric emergency admission was significantly lower (−54.1%) from the baseline (p=0.04), admissions from the general pediatric and adult wards did not show a significant difference.
Conclusions: Significant decreases in-hospital follow-up clinic visits were observed during the first months of the COVID-19 pandemic. Public health guidance on how best to access care, more for patients with serious illnesses are required. Promoting self-care, alternatives health-care services like home-based care, and phone clinics might be considered for patients with mild symptoms. Further studies needed to track the long-term effect of the pandemic among non-COVID-19 patients.
Keywords
Admission, COVID-19, Ethiopia, Follow-up visit, Health-care utilization, TASH, Trends.
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This preprint is under consideration at BMC Health Services Research. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Trends of Follow-Up Clinic Visits and Admissions Three-Months Before and During COVID-19 Pandemic at Tikur Anbessa Specialized Hospital, Ethiopia: an Interrupted Time Series Analysis
Workeabeba Abebe
Addis Ababa University
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 13 Jan, 2021
No community comments so far
Reviewers invited
Invitations sent on 14 Jan, 2021
Editor assigned
On 14 Jan, 2021
Editor invited
On 11 Jan, 2021
Submission checks complete
On 11 Jan, 2021
First submitted
On 25 Dec, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Following the first report of the COVID-19 case in Ethiopia on the 13th of March 2020, the country adopted a lockdown policy to contain the spread of the virus. Responding to the health-care burden imposed by the COVID-19 pandemic had to be coupled with ensuring essential health care services. This study assessed the impact of COVID-19 on the trends of non-COVID follow-up visits and admissions at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
Methods: A retrospective, time-series study with the 1st case of COVID-19 report as a reference time examined the trend in follow-up visits and admissions between December 1st, 2019 and May 31st, 2020. A comparison of health care utilization between December 2019 to May 2020 and its equivalent period in 2018/19 was also done. A data abstraction tool was used to collect secondary data from the hospital’s electronic medical recordings and logbooks of each unit.
Results: A total of 7,717 visits from eight follow-up clinics and 3,310 admissions were collected during three months before the onset of COVID-19. During the following three months after the pandemic, 4,597 visits and 2,383 admissions were collected. Overall, a 40.4% decrease in follow-up visits and a 28% decline in admissions were observed during the COVID-19. The drop in the daily follow-up visits was observed for both genders. The number of visits in all follow-up clinics in 2019/2020 decreased when compared to the same months in 2018/19(p<0.05). Follow-up visits were substantially lower for renal patients (-68%), patients with neurologic problems (−53.9%), antiretroviral treatment clinics (−52.3%), cardiac patients (−51.4%). Although pediatric emergency admission was significantly lower (−54.1%) from the baseline (p=0.04), admissions from the general pediatric and adult wards did not show a significant difference.
Conclusions: Significant decreases in-hospital follow-up clinic visits were observed during the first months of the COVID-19 pandemic. Public health guidance on how best to access care, more for patients with serious illnesses are required. Promoting self-care, alternatives health-care services like home-based care, and phone clinics might be considered for patients with mild symptoms. Further studies needed to track the long-term effect of the pandemic among non-COVID-19 patients.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Due to technical limitations, full-text HTML conversion of this manuscript could not be completed. However, the manuscript can be downloaded and accessed as a PDF.