JMIR Publications

ABSTRACT

Background:

The COVID-19 pandemic produced a global reduction in healthcare accessibility for patients with and without this infection, which was particularly burdening for those with chronic conditions as patients with a mental health condition. Peru was greatly affected by the pandemic, presenting a collapsed healthcare system conducing to the world’s highest per capita mortality rate due to COVID-19.

Objective:

Understanding the trends in healthcare utilization, and in mental health care use would provide insights into the pandemic response and future directions for recovery.

Methods:

This is an observational study from a national hospital in Lima, Peru. We analysed data on user care in all the services and in psychiatric services, for the period May 2019 to December 2022. Data were calculated for users served per month, and the number of users seen monthly in mental health services, as well as sociodemographic variables, were sex (female or male), age (from 0 to more), type of medical appointment (regular or additional), and modality of care (presential or teleconsultations). An interrupted time series regression model was conducted to assess the number of outpatient medical and psychiatric consultations. Subgroup analyses were performed according to service modality, i.e., overall, telemonitoring/tele-consultations only or face-to-face only for all service users and for mental health service users.

Results:

A total of 1,515,439 participants were included (females, 56.8%), and only 22.8% of all visits involved telemedicine. The total monthly outpatient visits were reduced significantly compared to the expected projection (p=0.000) at the beginning of the pandemic with a later monthly increment of 298.7 users. Face-to-face interventions were significantly reduced at the beginning, and progressively recovered through the following months. Telemedicine use presented an initial increment and subsequent reduction of use by the end of the pandemic. A similar trend was found in mental health units.

Conclusions:

During the pandemic years, healthcare utilization both in general and in psychiatric services significantly decreased, mostly at the beginning of the pandemic (March 2020). No significant trends were found in both cases across the pandemic times. Telemedicine attentions during this context increased significantly in general and mental-health users.