The indirect impact of COVID-19 pandemic on inpatient admissions in 204 Kenyan hospitals: An interrupted time series analysis.
Journal
PLOS global public health
ISSN: 2767-3375
Titre abrégé: PLOS Glob Public Health
Pays: United States
ID NLM: 9918283779606676
Informations de publication
Date de publication:
2021
2021
Historique:
received:
10
06
2021
accepted:
25
10
2021
entrez:
24
3
2023
pubmed:
17
11
2021
medline:
17
11
2021
Statut:
epublish
Résumé
The first case of severe acute respiratory coronavirus 2 (SARS-CoV-2) was identified in March 2020 in Kenya resulting in the implementation of public health measures (PHM) to prevent large-scale epidemics. We aimed to quantify the impact of COVID-19 confinement measures on access to inpatient services using data from 204 Kenyan hospitals. Data on monthly admissions and deliveries from the District Health Information Software version 2 (DHIS 2) were extracted for the period January 2018 to March 2021 stratified by hospital ownership (public or private) and adjusting for missing data using multiple imputation (MI). We used the COVID-19 event as a natural experiment to examine the impact of COVID-19 and associated PHM on use of health services by hospital ownership. We estimated the impact of COVID-19 using two approaches; Statistical process control (SPC) charts to visualize and detect changes and Interrupted time series (ITS) analysis using negative-binomial segmented regression models to quantify the changes after March 2020. Sensitivity analysis was undertaken to test robustness of estimates using Generalised Estimating Equations (GEE) and impact of national health workers strike on observed trends. SPC charts showed reductions in most inpatient services starting April 2020. ITS modelling showed significant drops in April 2020 in monthly volumes of live-births (11%), over-fives admissions for medical (29%) and surgical care (25%) with the greatest declines in the under-five's admissions (59%) in public hospitals. Similar declines were apparent in private hospitals. Health worker strikes had a significant impact on post-COVID-19 trends for total deliveries, live-births and caesarean section rate in private hospitals. COVID-19 has disrupted utilization of inpatient services in Kenyan hospitals. This might have increased avoidable morbidity and mortality due to non-COVID-19-related illnesses. The declines have been sustained. Recent data suggests a reversal in trends with services appearing to be going back to pre- COVID levels.
Identifiants
pubmed: 36962093
doi: 10.1371/journal.pgph.0000029
pii: PGPH-D-21-00130
pmc: PMC10021711
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e0000029Subventions
Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 207522/Z/17/Z
Pays : United Kingdom
Informations de copyright
Copyright: © 2021 Wambua et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Déclaration de conflit d'intérêts
The authors declare that they have no competing interests.
Références
BMJ Glob Health. 2018 Nov 28;3(6):e001136
pubmed: 30588346
BMJ Glob Health. 2016 May 24;1(1):e000028
pubmed: 27398232
Arch Dis Child. 2016 Mar;101(3):223-9
pubmed: 26662925
J Clin Pharm Ther. 2002 Aug;27(4):299-309
pubmed: 12174032
Science. 2021 Jan 1;371(6524):79-82
pubmed: 33177105
Clin Infect Dis. 2018 Oct 30;67(10):1559-1567
pubmed: 29668861
Trop Med Int Health. 2018 Aug;23(8):816-833
pubmed: 29799658
Front Neurol. 2020 Nov 05;11:584734
pubmed: 33250851
Surgeon. 2021 Oct;19(5):e207-e212
pubmed: 33257272
Implement Sci. 2013 Mar 28;8:39
pubmed: 23537192
Bull World Health Organ. 2020 Oct 01;98(10):671-682
pubmed: 33177757
Science. 2015 Mar 13;347(6227):1240-2
pubmed: 25766232
Acad Emerg Med. 1998 Jul;5(7):739-44
pubmed: 9678399
Int J Epidemiol. 2013 Aug;42(4):1187-95
pubmed: 23760528
Health Res Policy Syst. 2017 Feb 2;15(1):4
pubmed: 28153020
J Glob Health. 2020 Dec;10(2):020362
pubmed: 33110557
BMC Health Serv Res. 2018 Nov 9;18(1):846
pubmed: 30413159
Appl Health Econ Health Policy. 2018 Dec;16(6):859-869
pubmed: 30143994
Ecology. 2007 Nov;88(11):2766-72
pubmed: 18051645
World Neurosurg. 2021 Feb;146:e747-e754
pubmed: 33248310
Psychol Bull. 1995 Nov;118(3):392-404
pubmed: 7501743
BMJ Glob Health. 2020 Mar 31;5(3):e002108
pubmed: 32337080
Int J Epidemiol. 2017 Feb 1;46(1):348-355
pubmed: 27283160
PLoS One. 2020 Jul 20;15(7):e0236308
pubmed: 32687538
Glob Health Action. 2014 Jul 31;7:24859
pubmed: 25084834
Am J Med. 2021 Apr;134(4):482-489
pubmed: 33010226
Nat Hum Behav. 2021 Apr;5(4):529-538
pubmed: 33686204
Am J Public Health. 2004 Apr;94(4):562-4
pubmed: 15054005
Lancet. 2015 May 9;385(9980):1902-9
pubmed: 25987158
J Public Health (Oxf). 2016 Dec 02;38(4):673-678
pubmed: 28158472
BMC Med Res Methodol. 2021 Mar 22;21(1):58
pubmed: 33752604
Health Aff (Millwood). 2020 Nov;39(11):2010-2017
pubmed: 32970495
PLoS One. 2016 Feb 24;11(2):e0150080
pubmed: 26910462
BMC Health Serv Res. 2021 Jul 26;21(1):740
pubmed: 34311716
PLoS Curr. 2015 Aug 04;7:
pubmed: 26331094
BMJ Open. 2020 Oct 5;10(10):e043763
pubmed: 33020109
Stat Med. 2016 Jul 30;35(17):2938-54
pubmed: 26681666
Afr J Reprod Health. 2021 Dec;25(6):76-87
pubmed: 37585823