Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
COVID-19 Pandemisinin Sağlık Hizmetleri Erişimine Etkisinin Değerlendirilmesi: Kesitsel Bir Araştırma
Evaluation of the Impact of the COVID-19 Pandemic on Health Services Access: A Cross-Sectional Study
Emine ÇETİN ASLANa
aİzmir Bakırçay Üniversitesi Sağlık Bilimleri Fakültesi, Sağlık Yönetimi Bölümü, İzmir, Türkiye
Turkiye Klinikleri J Health Sci. 2022;7(2):534-43
doi: 10.5336/healthsci.2021-84653
Article Language: TR
Full Text
ÖZET
 Amaç: Araştırmanın amacı, koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)] ile mücadelede, sağlık sektörü içerisinde ve dışında alınan önlemlerin, toplumun sağlık hizmetlerine erişimine etkisini değerlendirmektedir. Ayrıca bazı tanımlayıcı değişkenlerin, salgın dönemindeki sağlık hizmeti alımına etkisi incelenmiştir. Gereç ve Yöntemler: Bu çalışma, kesitsel bir saha araştırmasıdır. Araştırma verileri, anket aracığıyla toplanmış. Araştırmaya, Türkiye genelinde 1.148 gönüllü katılmıştır. Verilerin analizinde tanımlayıcı analizler ve ki-kare testi kullanılmıştır. Bulgular: COVID-19 pandemi döneminde 767 (%66,8) kişi herhangi bir neden ile sağlık hizmeti almaktan vazgeçmiştir ya da talebi ertelemiştir. Herhangi bir kronik hastalığı olanlar, tansiyon, diyabet ve astım hastaları, 65 ve üzeri yaştakiler ile kadınlar, karşıt gruplarına göre sağlık hizmeti alımlarını istatistiksel olarak anlamlı oranda daha fazla ertelemişlerdir. Hizmet talebini erteleme nedenleri içinde en sık belirtilen iki neden: Hastalığa yakalanma korkusu ve randevu bulamamaktır. En fazla ertelenen sağlık hizmeti türleri; poliklinik hizmetleri ile ağız ve diş sağlığı hizmetleridir. Katılımcıların %11,7'si COVID-19 geçirmiş ve %22,6'sı temaslı olmuştur. Hastalığı geçirenlerin ve temaslıların sağlık hizmeti almakta en sık yaşadığı sorun, test yaptırmak olmuştur. Sonuç: Araştırmada, COVID19 pandemisinin, dünya genelinde ve diğer salgınlarda da olduğu gibi sağlık hizmetlerine erişimi olumsuz etkilediği sonucuna varılmıştır. Pandeminin sağlık hizmetleri erişimi üzerine etkisi, sağlık hizmeti türüne göre değişmekte olup; hem arz hem de talep kaynaklı nedenleri bulunmaktadır.

Anahtar Kelimeler: COVID-19; ertelenen sağlık hizmeti talebi; sağlık hizmetlerine erişim; pandemi
ABSTRACT
 Objective: The aim of the study is to evaluate the impact of the measures that taken inside and outside the health sector on the public's access to health services to combat coronavirus disease2019 (COVID-19). In addition, the effect of some descriptive variables on healthcare usage during the epidemic period was examined. Material and Methods: This study is a cross-sectional field research. The research data were collected through a questionnaire. 1,148 volunteers participated in the study across Turkey. Descriptive analysis and chisquare tests were used in the analysis of the data. Results: 767 (66.8%) people gave up using the health service for any reason during the COVID-19 pandemic. The person with any chronic diseases, hypertension, diabetes, asthma, and those aged 65 and over, and women were more frequently postponed their healthcare needs than the counterparts (statistically significantly). The two most common reasons for not using the services are the fear of COVID-19 and not being able to find an appointment. The most postponed health services are outpatient visits and dental health services. 11.7% of the participants have had COVID-19 and 22.6% of participants have suspected illness. The most common problem of the persons that experienced during COVID-19 and being suspect of illness were getting a test. Conclusion: The study concluded that the COVID-19 pandemic negatively affected access to healthcare services, as in the world and other epidemics. The amount of impact on demand for healthcare services varies according to the health service, and there are both supply and demand-based reasons. The impact of the pandemic on access to health services varies according to the type of health service and has both supply and demand-based causes.

Keywords: COVID-19; delayed healthcare demand; access to healthcare; pandemic
REFERENCES:
  1. Kieny MP, Evans DB, Schmets G, Kadandale S. Health-system resilience: Reflections on the Ebola crisis in western Africa. Bull World Health Organ. 2014;92(12):850. [Crossref]  [PubMed]  [PMC] 
  2. World Health Organization. Managing Epidemics: Key Facts about Major Deadly Diseases. Geneva: World Health Organization; 2018. [Link] 
  3. World Health Organization [İnternet]. ©2021 WHO. [Erişim tarihi: 14.05.2021]. WHO coronavirus (COVID-19) dashboard. Erişim linki: [Link] 
  4. Roberton T, Carter ED, Chou VB, Stegmuller AR, Jackson BD, Tam Y, et al. Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study. Lancet Glob Heal. 2020; 8(7):901-8. [Crossref] 
  5. Brolin Ribacke KJ, Saulnier DD, Eriksson A, von Schreeb J. Effects of the west Africa Ebola virus disease on health-care utilization - a systematic review. Front Public Health. 2016;4: 222. [Crossref]  [PubMed]  [PMC] 
  6. Li R, Pei S, Chen B, Song Y, Zhang T, Yang W, et al. Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV-2). Science. 2020; 368(6490):489-93. [Crossref]  [PubMed]  [PMC] 
  7. Lambertini M, Toss A, Passaro A, Criscitiello C, Cremolini C, Cardone C, et al. Cancer care during the spread of coronavirus disease 2019 (COVID-19) in Italy: young oncologists' perspective. ESMO Open. 2020;5(2):e000759. [Crossref]  [PubMed]  [PMC] 
  8. Iyengar K, Mabrouk A, Jain VK, Venkatesan A, Vaishya R. Learning opportunities from COVID-19 and future effects on health care system. Diabetes Metab Syndr. 2020;14(5): 943-6. [Crossref]  [PubMed]  [PMC] 
  9. World Health Organization. Pulse survey on continuity of essential health services during the COVID-19 pandemic. Interim Report 27 August 2020. (Erişim Tarihi: 30 Nisan 2021) [Link] 
  10. World Health Organization {İnternet]. © 2021 WHO [Erişim tarihi:10.07.2021]. COVID-19 significantly impacts health services for noncommunicable diseases. Published 2020. Erişim linki: [Link] 
  11. World Health Organization. Maintaining essential health services: operational guidance for the COVID-19 context. 2020. (Erişim Tarihi: 02 Mayıs 2021) Erişim linki: [Link] 
  12. Elston JW, Moosa AJ, Moses F, Walker G, Dotta N, Waldman RJ, et al. Impact of the Ebola outbreak on health systems and population health in Sierra Leone. J Public Health (Oxf). 2016;38(4):673-8. [PubMed] 
  13. Ahmed SAKS, Ajisola M, Azeem K, Bakibinga P, Chen YF, Choudhury NN, et al; Improving Health in Slums Collaborative. Impact of the societal response to COVID-19 on access to healthcare for non-COVID-19 health issues in slum communities of Bangladesh, Kenya, Nigeria and Pakistan: results of pre-COVID and COVID-19 lockdown stakeholder engagements. BMJ Glob Health. 2020; 5(8):e003042. [Crossref]  [PubMed]  [PMC] 
  14. Deerberg-Wittram J, Knothe C. Do not stay at home: we are ready for you. NEJM Catal. 2020;202:1-7. [Crossref] 
  15. Neal RD, Nekhlyudov L, Wheatstone P, Koczwara B. Cancer care during and after the pandemic. BMJ. 2020;370:1-2. [Crossref]  [PubMed] 
  16. Bolkan HA, Bash-Taqi DA, Samai M, Gerdin M, von Schreeb J. Ebola and indirect effects on health service function in sierra leone. PLoS Curr. 2014;6. [Crossref]  [PubMed]  [PMC] 
  17. Delamou A, Hammonds RM, Caluwaerts S, Utz B, Delvaux T. Ebola in Africa: beyond epidemics, reproductive health in crisis. Lancet. 2014;384(9960):2105. [Crossref]  [PubMed] 
  18. Sağlık Bakanlığı. Elektif işlemlerin ertelenmesi ve diğer alınacak tedbirler. 2020.(Erişim Tarihi: 30 Nisan 2021) Erişim linki: [Link] 
  19. Coşkun R, Altunışık R, Yıldırım E. Sosyal Bilimlerde Araştırma Yöntemleri: SPSS Uygul amalı. 10. Baskı. Sakarya: Sakarya Yayıncılık; 2019. [Link] 
  20. Cohen L, Lawrence M, Keith M. Research Methods in Education. 5th ed. London: Routledge Falmer; 2000. [Link] 
  21. Sevinç C, Tertemiz KC, Atik M, Güler N, Ulusoy M, Coşkun F, et al. How were Non-COVID pulmonary patients and diseases affected from COVID-19 pandemic period? Turk Thorac J. 2021;22(2):149-53. [Crossref]  [PubMed]  [PMC] 
  22. Wong LE, Hawkins JE, Langness S, Murrell KL, Iris P, Sammann A. Where are all the patients? Addressing Covid-19 fear to encourage sick patients to seek emergency care. NEJM Catal. Published online 2020:1-12. [Link] 
  23. Hartnett KP, Kite-Powell A, DeVies J, Coletta MA, Boehmer TK, Adjemian J, et al; National Syndromic Surveillance Program Community of Practice. Impact of the COVID-19 pandemic on emergency department visits-United States, January 1, 2019-May 30, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(23): 699-704. [Crossref]  [PubMed]  [PMC] 
  24. Morelli N, Rota E, Terracciano C, Immovilli P, Spallazzi M, Colombi D, et al. The baffling case of ischemic stroke disappearance from the casualty department in the COVID-19 era. Eur Neurol. 2020;83(2):213-5. [Crossref]  [PubMed]  [PMC] 
  25. Houshyar R, Tran-Harding K, Glavis-Bloom J, Nguyentat M, Mongan J, Chahine C, et al. Effect of shelter-in-place on emergency department radiology volumes during the COVID-19 pandemic. Emerg Radiol. 2020;27(6):781-4. [Crossref]  [PubMed]  [PMC] 
  26. Simsek P, Ilhan E, Bulbul O, Ucuncu E, Topbas M, Gunduz A. How did the COVID-19 pandemic affect inappropriate adult emergency department attendances?: a prospective cross-sectional study. Med Bull İstanbul Haseki Train Res Hosp. 2021;59:96-102. [Crossref] 

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