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Changes in usual source of care utilization during the COVID-19 pandemic: a comparative analysis by chronic disease

Seokmin Ji1, Sewon Park2, Munjae Lee3

  • 1Department of Public Health & AI, Graduate School of Cancer Science and Policy, National Cancer Center, Gyeonggi, South Korea.

BMC Health Services Research
|May 29, 2026
PubMed

Insights

The COVID-19 pandemic reduced clinic visits for older adults with chronic conditions, impacting their primary care access. Healthcare policies must prioritize vulnerable populations during public health emergencies to ensure care continuity.

Area of Science:

  • Public Health
  • Healthcare Systems Research
  • Epidemiology

Background:

  • The COVID-19 pandemic significantly disrupted global healthcare, reducing outpatient visits, especially for chronic conditions and older adults.
  • South Korea observed decreased outpatient utilization, raising concerns about unmet needs and continuity of care.
  • Pandemic-induced disruptions highlighted the vulnerability of patients requiring regular medical management.

Purpose of the Study:

  • To analyze the impact of the COVID-19 pandemic on outpatient healthcare utilization in South Korea.
  • To examine variations in utilization based on chronic disease status, age, and usual source of care (USC).

Main Methods:

  • Utilized Korean Health Panel (KHPS) data from January 2019 to December 2020.
  • Employed interrupted time series analysis (ITSA).
  • Stratified analysis by chronic condition status (non-chronic vs. chronic) and age (under 65 vs. 65+), and by USC type (clinics, hospitals, general hospitals).

Main Results:

  • Clinic visits declined for non-chronic individuals under 65 and all chronic disease patients post-first intervention, with rebounds after the second.
  • Visits to hospitals and general hospitals increased during the pandemic.
  • Overall outpatient utilization rose in the non-chronic group but fell for older adults with chronic conditions.

Conclusions:

  • COVID-19 pandemic's effect on outpatient utilization varied by age, health status, and USC type.
  • Reduced clinic visits among older adults with chronic conditions signify diminished primary care access.
  • Findings emphasize the need for policies protecting vulnerable populations and prioritizing primary care during health emergencies.
Abstract

Keywords:
COVID-19Chronic diseasesHealthcare utilizationInterrupted time series analysisUsual source of care

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