Open Access

PLoS ONE

, volume 18 , issue 9 , pages e0290646

The impact of the early COVID-19 pandemic on healthcare system resource use and costs in two provinces in Canada: An interrupted time series analysis

Seraphine Zeitouny ¹

Douglas C. Cheung ²

K. E. Bremner ³

Reka E Pataky ¹

Priscila Pequeno ⁴

John Matelski ⁵

Stuart Peacock ¹

M Elisabeth Del Giudice ⁶

Lauren Lapointe‐Shaw ⁷

George Tomlinson ⁵

Andrew Mendlowitz ²

Carol Mulder ⁸

Teresa C O Tsui ⁷

Nathan Perlis ⁹

JENNIFER D. WALKER ⁷

Beate Sander ²

William W L Wong ⁷

Murray D Krahn ²

GIRISH S. KULKARNI ⁹

Hide authors affiliations Show authors affiliations: 9 affiliations

Canadian Centre for Applied Research in Cancer Control, BC Cancer, Vancouver, British Columbia, Canada, |

Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, Ontario, Canada, |

Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, Ontario, Canada |

⁴

ICES, Toronto, Ontario, Canada |

⁵

Biostatistics Research Unit, University Health Network, Toronto, Ontario, Canada |

⁶

Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada, |

⁷

ICES, Toronto, Ontario, Canada, |

⁸

Chiefs of Ontario, Toronto, Ontario, Canada, |

⁹

Divisions of Urology and Surgical Oncology, Department of Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada, |

Publication type: Journal Article

Publication date: 2023-09-08

Public Library of Science (PLoS)

PLoS ONE

scimago Q1

wos Q2

SJR: 0.803

CiteScore: 5.4

Impact factor: 2.6

ISSN: 19326203

DOI: 10.1371/journal.pone.0290646

Copy DOI

PubMed ID: 37682823

Multidisciplinary

Abstract

Introduction

The aim of our study was to assess the initial impact of COVID-19 on total publicly-funded direct healthcare costs and health services use in two Canadian provinces, Ontario and British Columbia (BC).

Methods

This retrospective repeated cross-sectional study used population-based administrative datasets, linked within each province, from January 1, 2018 to December 27, 2020. Interrupted time series analysis was used to estimate changes in the level and trends of weekly resource use and costs, with March 16–22, 2020 as the first pandemic week. Also, in each week of 2020, we identified cases with their first positive SARS-CoV-2 test and estimated their healthcare costs until death or December 27, 2020.

Results

The resources with the largest level declines (95% confidence interval) in use in the first pandemic week compared to the previous week were physician services [Ontario: -43% (-49%,-37%); BC: -24% (-30%,-19%) (both p<0.001)] and emergency department visits [Ontario: -41% (-47%,-35%); BC: -29% (-35%,-23%) (both p<0.001)]. Hospital admissions declined by 27% (-32%,-23%) in Ontario and 21% (-26%,-16%) in BC (both p<0.001). Resource use subsequently rose but did not return to pre-pandemic levels. Only home care and dialysis clinic visits did not significantly decrease compared to pre-pandemic. Costs for COVID-19 cases represented 1.3% and 0.7% of total direct healthcare costs in 2020 in Ontario and BC, respectively.

Conclusions

Reduced utilization of healthcare services in the overall population outweighed utilization by COVID-19 patients in 2020. Meeting the needs of all patients across all services is essential to maintain resilient healthcare systems.

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Zeitouny S. et al. The impact of the early COVID-19 pandemic on healthcare system resource use and costs in two provinces in Canada: An interrupted time series analysis // PLoS ONE. 2023. Vol. 18. No. 9. p. e0290646.

GOST all authors (up to 50) Copy

Zeitouny S., Cheung D. C., Bremner K. E., Pataky R. E., Pequeno P., Matelski J., Peacock S., Del Giudice M. E., Lapointe‐Shaw L., Tomlinson G., Mendlowitz A., Mulder C., Tsui T. C. O., Perlis N., WALKER J. D., Sander B., Wong W. W. L., Krahn M. D., KULKARNI G. S. The impact of the early COVID-19 pandemic on healthcare system resource use and costs in two provinces in Canada: An interrupted time series analysis // PLoS ONE. 2023. Vol. 18. No. 9. p. e0290646.

RIS |

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RIS Copy

TY - JOUR

DO - 10.1371/journal.pone.0290646

UR - https://doi.org/10.1371/journal.pone.0290646

TI - The impact of the early COVID-19 pandemic on healthcare system resource use and costs in two provinces in Canada: An interrupted time series analysis

T2 - PLoS ONE

AU - Zeitouny, Seraphine

AU - Cheung, Douglas C.

AU - Bremner, K. E.

AU - Pataky, Reka E

AU - Pequeno, Priscila

AU - Matelski, John

AU - Peacock, Stuart

AU - Del Giudice, M Elisabeth

AU - Lapointe‐Shaw, Lauren

AU - Tomlinson, George

AU - Mendlowitz, Andrew

AU - Mulder, Carol

AU - Tsui, Teresa C O

AU - Perlis, Nathan

AU - WALKER, JENNIFER D.

AU - Sander, Beate

AU - Wong, William W L

AU - Krahn, Murray D

AU - KULKARNI, GIRISH S.

PY - 2023

DA - 2023/09/08

PB - Public Library of Science (PLoS)

SP - e0290646

IS - 9

VL - 18

PMID - 37682823

SN - 1932-6203

ER -

BibTex |

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BibTex (up to 50 authors) Copy

@article{2023_Zeitouny,

author = {Seraphine Zeitouny and Douglas C. Cheung and K. E. Bremner and Reka E Pataky and Priscila Pequeno and John Matelski and Stuart Peacock and M Elisabeth Del Giudice and Lauren Lapointe‐Shaw and George Tomlinson and Andrew Mendlowitz and Carol Mulder and Teresa C O Tsui and Nathan Perlis and JENNIFER D. WALKER and Beate Sander and William W L Wong and Murray D Krahn and GIRISH S. KULKARNI},

title = {The impact of the early COVID-19 pandemic on healthcare system resource use and costs in two provinces in Canada: An interrupted time series analysis},

journal = {PLoS ONE},

year = {2023},

volume = {18},

publisher = {Public Library of Science (PLoS)},

month = {sep},

url = {https://doi.org/10.1371/journal.pone.0290646},

number = {9},

pages = {e0290646},

doi = {10.1371/journal.pone.0290646}

}

MLA

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MLA Copy

Zeitouny, Seraphine, et al. “The impact of the early COVID-19 pandemic on healthcare system resource use and costs in two provinces in Canada: An interrupted time series analysis.” PLoS ONE, vol. 18, no. 9, Sep. 2023, p. e0290646. https://doi.org/10.1371/journal.pone.0290646.

Publisher

Public Library of Science (PLoS)

Journal

PLoS ONE

scimago Q1

wos Q2

SJR

0.803

CiteScore

5.4

Impact factor

2.6

ISSN

19326203 (Print, Electronic)