Changes in healthcare use by age groups of patients and locations of healthcare institutions after the COVID-19 pandemic in Korea: Analyzing healthcare big data

OBJECTIVES: The COVID-19 pandemic affected healthcare use globally. However, there have been few studies examining how it affected age-specific healthcare use by patients as related to the locations of healthcare institutions. We explore changes in healthcare use while focusing on age-specific patient groups and facility locations after the COVID-19 pandemic. METHODS: We compared two databases of cross-sectional outpatient health-insurance claims that have equivalent time points yearly and quarterly both before and after the COVID-19 pandemic. We categorized patients of healthcare institutions into five age groups and two facility locations. RESULTS: The number of claims in 2020 significantly decreased by about 15% compared to 2019. The greatest reduction was for patients aged under 20 (-43.7%), followed by the 20–39 group (-15.0%) and the 40–59 group (-11.9%). Moreover, the number of claims significantly decreased in both urban and rural areas (p< 0.001); however, the magnitude of this decrease was greater in urban areas (-15.2%) than in rural areas (-10.8%). The annual decrease in healthcare use by age groups and location of facility was still supported even after controlling for institutional covariates, except for the patient group aged 80 or over in rural areas. CONCLUSIONS: We found that the COVID-19 pandemic critically affected healthcare use across age-specific population groups and different locations of healthcare institutions. It suggests there is a need for further research and policy implications as to whether the declining healthcare use among those age groups is in core health care, and as to whether there are any unmet healthcare needs.