Associations between the stringency of COVID-19 containment policies and health service disruptions in 10 countries

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dc.article.number363
dc.catalogadorcrc
dc.contributor.authorReddy, Tarylee
dc.contributor.authorKapoor, Neena R.
dc.contributor.authorKubota, Shogo
dc.contributor.authorDoubova, Svetlana V.
dc.contributor.authorAsai, Daisuke
dc.contributor.authorMariam, Damen H.
dc.contributor.authorAyele, Wondimu
dc.contributor.authorMebratie, Anagaw D.
dc.contributor.authorThermidor, Roody
dc.contributor.authorSapag Muñoz de la Peña, Jaime
dc.contributor.authorBedregal, Paula
dc.contributor.authorPassi-Solar, Álvaro
dc.contributor.authorGordon-Strachan, Georgiana
dc.contributor.authorDulal, Mahesh
dc.contributor.authorGadeka, Dominic D.
dc.contributor.authorMehata, Suresh
dc.contributor.authorMargozzini Maira, Paula
dc.contributor.authorLeerapan, Borwornsom
dc.contributor.authorRittiphairoj, Thanitsara
dc.contributor.authorKaewkamjornchai, Phanuwich
dc.contributor.authorNega, Adiam
dc.contributor.authorAwoonor-Williams, John K.
dc.contributor.authorKruk, Margaret E.
dc.contributor.authorArsenault, Catherine
dc.date.accessioned2023-04-17T19:32:24Z
dc.date.available2023-04-17T19:32:24Z
dc.date.issued2023
dc.date.updated2023-04-16T00:02:38Z
dc.description.abstractBackground Disruptions in essential health services during the COVID-19 pandemic have been reported in several countries. Yet, patterns in health service disruption according to country responses remain unclear. In this paper, we investigate associations between the stringency of COVID-19 containment policies and disruptions in 31 health services in 10 low- middle- and high-income countries in 2020. Methods Using routine health information systems and administrative data from 10 countries (Chile, Ethiopia, Ghana, Haiti, Lao People’s Democratic Republic, Mexico, Nepal, South Africa, South Korea, and Thailand) we estimated health service disruptions for the period of April to December 2020 by dividing monthly service provision at national levels by the average service provision in the 15 months pre-COVID (January 2019-March 2020). We used the Oxford COVID-19 Government Response Tracker (OxCGRT) index and multi-level linear regression analyses to assess associations between the stringency of restrictions and health service disruptions over nine months. We extended the analysis by examining associations between 11 individual containment or closure policies and health service disruptions. Models were adjusted for COVID caseload, health service category and country GDP and included robust standard errors. Findings Chronic disease care was among the most affected services. Regression analyses revealed that a 10% increase in the mean stringency index was associated with a 3.3 percentage-point (95% CI -3.9, -2.7) reduction in relative service volumes. Among individual policies, curfews, and the presence of a state of emergency, had the largest coefficients and were associated with 14.1 (95% CI -19.6, 8.7) and 10.7 (95% CI -12.7, -8.7) percentage-point lower relative service volumes, respectively. In contrast, number of COVID-19 cases in 2020 was not associated with health service disruptions in any model. Conclusions Although containment policies were crucial in reducing COVID-19 mortality in many contexts, it is important to consider the indirect effects of these restrictions. Strategies to improve the resilience of health systems should be designed to ensure that populations can continue accessing essential health care despite the presence of containment policies during future infectious disease outbreaks.
dc.fechaingreso.objetodigital2023-04-17
dc.format.extent11 páginas
dc.fuente.origenAutoarchivo
dc.identifier.citationReddy, T., Kapoor, N.R., Kubota, S. et al. Associations between the stringency of COVID-19 containment policies and health service disruptions in 10 countries. BMC Health Serv Res 23, 363 (2023). https://doi.org/10.1186/s12913-023-09363-1
dc.identifier.doi10.1186/s12913-023-09363-1
dc.identifier.urihttps://doi.org/10.1186/s12913-023-09363-1
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/66778
dc.information.autorucEscuela de Medicina ; Sapag Muñoz de la Peña, Jaime ; s/i ; 3511
dc.information.autorucEscuela de medicina ; Bedregal, Paula ; 0000-0003-3550-9117 ; 79369
dc.information.autorucEscuela de Medicina ; Passi Solar, Alvaro Rodrigo ; 0000-0002-1744-1705 ; 155739
dc.information.autorucEscuela de Medicina ; Margozzini Maira, Paula ; 0000-0002-3919-0070 ; 63265
dc.language.isoen
dc.nota.accesoContenido completo
dc.revistaBMC Health Services Research
dc.rightsacceso abierto
dc.rights.holderThe Author(s)
dc.rights.licenseCC0 1.0 Universal (CC0 1.0) Public Domain Dedication
dc.rights.urihttps://creativecommons.org/publicdomain/zero/1.0/
dc.subjectCOVID-19 restrictions
dc.subjectHealth systems
dc.subjectHealth services
dc.subjectPandemic response
dc.subjectHealth system resilience
dc.subjectHealth care disruptions
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.titleAssociations between the stringency of COVID-19 containment policies and health service disruptions in 10 countries
dc.typeartículo
dc.volumen23
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