Related Experiment Video
Updated: Oct 14, 2025
Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
Published on: August 9, 2024
The Impact of COVID-19 on Hospital Admissions for Twelve High-Burden Diseases and Five Common Procedures in the
Jhanna Uy1,2, Vanessa T Siy Van1, Valerie Gilbert Ulep2,3
1Health Sciences Program, Ateneo de Manila University, Quezon City, Philippines.
Insights
COVID-19 significantly reduced hospital admissions for 12 diseases in the Philippines during 2020. Vulnerable populations and lower-level hospitals experienced greater declines in care access.
Area of Science:
- Public Health
- Health Services Research
- Epidemiology
Background:
- The Philippines faced high COVID-19 burden, necessitating an examination of pandemic's wider health system effects.
- Assessing changes in hospital admissions and procedures provides insight into healthcare access during the pandemic.
Purpose of the Study:
- To evaluate the impact of COVID-19 lockdowns on hospital admissions for 12 major diseases and utilization of five common procedures.
- To analyze these changes based on lockdown stringency, hospital level, and patient access equity.
Main Methods:
- Utilized Philippine social health insurance data from 1,295 hospitals for 2019 and 2020.
- Calculated year-on-year, same-month-prior-year, and lockdown period percent changes in admissions and procedures.
Main Results:
- Overall disease admissions decreased by 54%, while procedures rose by 13% in 2020 versus 2019, driven by hemodialysis.
- Declines were most significant during initial lockdowns (March-April 2020) and disproportionately affected the poorest and southern regions.
- Lower-level and private hospitals showed varied impacts, with some experiencing increased procedure utilization.
Conclusions:
- The pandemic's sustained effect on hospital service utilization signals a potential public health crisis in nations with fragile health systems.
- A comprehensive health strategy is crucial, addressing all conditions, service networks, and vulnerable populations during health crises.
Background:
The Philippines has the highest cumulative COVID-19 cases and deaths in the Western-Pacific. To explore the broader health impacts of the pandemic, we assessed the magnitude and duration of changes in hospital admissions for 12 high-burden diseases and the utilization of five common procedures by lockdown stringency, hospital level, and equity in patient access.
Methods:
Our analysis used Philippine social health insurance data filed by 1,295 hospitals in 2019 and 2020. We calculated three descriptive statistics of percent change comparing 2020 to the same periods in 2019: (1) year-on-year, (2) same-month-prior-year, and (3) lockdown periods.
Findings:
Disease admissions declined (-54%) while procedures increased (13%) in 2020 versus 2019. The increase in procedures was caused by hemodialysis surpassing its 2019 utilization levels in 2020 by 25%, overshadowing declines for C-section (-5%) and vaginal delivery (-18%). Comparing months in 2020 to the same months in 2019, the declines in admissions and procedures occurred at pandemic onset (March-April 2020), with some recovery starting May, but were generally not reversed by the end of 2020. Non-urgent procedures and respiratory diseases faced the largest declines in April 2020 versus April 2019 (range: -60% to -70%), followed by diseases requiring regular follow-up (-50% to -56%), then urgent conditions (-4% to -40%). During the strictest (April-May 2020) and relaxed (May-December 2020) lockdown periods compared to the same periods in 2019, the declines among the poorest (-21%, -39%) were three-times greater than in direct contributors (-7%, -12%) and two-times more in the south (-16%, -32%) than the richer north (-8%, -10%). Year-on-year admission declines across the 12 diseases and procedures (except for hemodialysis) was highest for level three hospitals. Compared to public hospitals, private hospitals had smaller year-on-year declines for procedures, because of increases in utilization in lower level private hospitals.
Interpretation:
COVID-19's prolonged impact on the utilization of hospital services in the Philippines suggests a looming public health crisis in countries with frail health systems. Through the periodic waves of COVID-19 and lockdowns, policymakers must employ a whole-of-health strategy considering all conditions, service delivery networks, and access for the most vulnerable.
Funding:
Open Philanthropy.
Related Concept Videos
01:29Issues And Trends In Healthcare Delivery System
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:28Hospitals-I
01:30Health Information Technology and Healthcare Information System
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
01:11Secondary Healthcare System
01:18Introduction To Health Care Delivery System
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...