Comparison of Outpatient Services Utilization Before and After the COVID-19 Outbreak at Base Hospital Homagama

Background: The Outpatient Department is where patients receive healthcare services for minor conditions that can be managed without hospital admission. During the COVID-19 pandemic, healthcare utilization decreased drastically, with variations across different areas of patient care.
Objective: Our objective was to identify the differences in outpatient service utilization before and after the COVID-19 outbreak at Base Hospital Homagama.
Methods: A cross-sectional descriptive study was conducted to compare OPD service utilization before and after the COVID-19 outbreak at Base Hospital Homagama. Data were collected using the hospital’s health information system. All patient visits were entered into the computerized hospital information system in 2019, and 2022 were included. Patients who received OPD services in 2019 were considered “before the COVID-19 period” and those who received services in 2022 were considered “after the COVID-19 period”. Data collection utilized the hospital’s information system (HIS) report module to obtain aggregated data on patient encounters, reasons for encounters, age categories, prescriptions, procedures, and investigations. Additional analyses, including reasons for encounters by age and gender and their associated procedures and investigations, were conducted using MySQL and analyzed using SPSS. Ethical approval was obtained from the Ethical Review Committee of the Faculty of Medicine, General Sir John Kotelawala Defense University prior to the commencement of the research.
Results: The total number of OPD visits was higher in 2019 than that in 2022, which was also reflected in the daily average attendance of patients. The percentage of newly registered patients compared to the total number of OPD visits was similar in both 2019 and 2022. However, the number of prescriptions issued, relative to the total number of OPD visits, was higher in 2019. There was a significant variation in weekly OPD visits in 2019 compared to 2022 (P < 0.05). The number of OPD visits decreased across all age groups by 2022 compared to 2019. The percentage of OPD visits for the 14-49 year age group was similar for both 2019 and 2022. However, there was an increase in the number of OPD visits for the age group over 49 years in 2022 compared with 2019. The average waiting time for doctor consultations and dispensary services in 2022 was shorter than that in 2019. The percentage of patients with Upper Respiratory Tract Infection symptoms decreased by 2022 (17.5%) compared to that in 2019 (18.7%). There was a reduction in the number of patients with musculoskeletal complaints (joint pain and back pain), dermatological problems, and wound dressing in 2022 compared to 2019. However, there was an increase in the number of patients with wheezing in 2022 (1.8%) compared with 2019 (0.7%). The percentage of patients undergoing OPD procedures has increased from 20% in 2019 to 27% in 2022. DOTS treatment was completely discontinued in 2022.
Conclusion: In 2022, OPD visits decreased across all age groups compared with 2019, with notable increases in visits for patients over 49 years, shorter waiting times, and a higher percentage of OPD procedures.