Trends of healthcare utilization during COVID-19 in an Egyptian university hospital: a special emphasis on oncology patients’ services

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Abstract Background: COVID-19 pandemic has reduced healthcare utilization worldwide and no sufficient studies were published from resource-limited countries. This study aimed to quantify and characterize the changes in service utilization within years 2020–2021 in one of the Egyptian university hospitals, with special emphasis on oncology services. Methods: Data were longitudinally collected for various services and categorized as for all-hospital patients and for oncology patients. Percentage reduction was calculated compared to year 2019. Results: For all-hospital patients, the overall utilization reduced by –23.2% in 2020 and –3.6% in 2021. Also, emergency room visits were reduced (–22.7% in 2020; –17.5% in 2021). For oncology patients, greater reduction was recorded in overall services (–43.7% in 2020; –37.4% in 2021). Reduction, that showed fluctuation according to COVID-19 waves in Egypt, was larger in diagnostic (–44.8% in 2020; –45.4% in 2021) and screening services (–71.2% in 2020; –58.2% in 2021) than therapeutic (–36.2% in 2020; –31.4% in 2021). Despite its much reduction in 2020 (–31.5%), surgeries were the fastest to approach its pre-pandemic level (–1.4%) in 2021. Still lagging services were admissions, outpatient visits, radiotherapy, diagnostics, and screening. Conclusion: With marked utilization reduction, a higher disease burden, stage migration, and premature death is anticipated. Reduction of emergency visits may raise questions for redefining what constitutes an “actual” emergency; or conversely, whether late presentations and/or preventable deaths have occurred. Preparation for, and evaluation of the impact of such experience are needed from policy/decision makers and researchers as well.

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