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COVID-19 대유행 동안의 병원 회피 현상 및 연관 요인

Hospital Avoidance and Associated Factors During the COVID-19 Pandemic

  • 전종욱 (한양대학교 의과대학 명지병원 정신건강의학과) ;
  • 김세주 (연세대학교 의과대학 정신과학교실 의학행동과학연구소) ;
  • 이수영 (한양대학교 의과대학 명지병원 정신건강의학과) ;
  • 장진구 (한양대학교 의과대학 명지병원 정신건강의학과) ;
  • 김찬형 (연세대학교 의과대학 정신과학교실 의학행동과학연구소)
  • Jong-Wook Jeon (Department of Psychiatry, Myongji Hospital, Hanyang University College of Medicine) ;
  • Se Joo Kim (Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine) ;
  • Su-Young Lee (Department of Psychiatry, Myongji Hospital, Hanyang University College of Medicine) ;
  • Jhin Goo Chang (Department of Psychiatry, Myongji Hospital, Hanyang University College of Medicine) ;
  • Chan-Hyung Kim (Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine)
  • 투고 : 2023.09.07
  • 심사 : 2023.10.07
  • 발행 : 2023.10.30

초록

본 연구는 COVID-19 대유행 이전부터 병원을 이용한 환자들의 관점에서 병원 회피와 연관 요인을 조사했다는 점에서 의미가 있다. 감염병 위기 기간 동안 병원 회피에 대응하기 위해서는 병원내 감염 관리 대책의 준비와 환자들과의 적극적인 소통이 필요하다. 이 연구는 향후 전염병 위기 기간 동안의 병원 회피에 대한 의료 정책을 포함한 대응책의 준비에 기여할 수 있을 것이다.

Objective : During the coronavirus disease 2019 (COVID-19) pandemic, hospital avoidance had a significant impact on public health. We investigated the factors associated with hospital avoidance and explored practical strategies hospitals could employ to address this phenomenon. Methods : We conducted a patient experience survey in a general hospital in Korea during the COVID-19 pandemic. Between July 6, 2020, and July 20, 2020, a total of 842 patients who had previously visited hospitals before the COVID-19 outbreak participated. Self-reported hospital avoidance, factors associated with hospital avoidance, and satisfaction with the hospital's infection control policies were the main outcomes. Binary logistic regression analysis was used to identify associated factors. Results : Data indicated that 29.9% (n=252) of the respondents avoided visiting the hospital after the COVID-19 outbreak. Satisfaction with the hospital infection control policy (odds ratio [OR]=2.297, p<0.001), female sex (OR=1.619, p<0.05), and higher educational level (OR=1.884, p<0.001) were associated with hospital avoidance. The "entrance body temperature check" was the most satisfactory policy among the hospital's infection control policies. Conclusion : To manage hospital avoidance during an infectious disease crisis, targeted policies for at-risk groups and hospital policies to reassure and satisfy patients are needed.

키워드

참고문헌

  1. Sohrabi C, Alsafi Z, O'Neill N, Khan M, Kerwan A, Al-Jabir A, et al. World Health Organization declares global emergency: a review of the 2019 novel coronavirus (COVID-19). International Journal of Surgery2020;76:71-76. https://doi.org/10.1016/j.ijsu.2020.02.034
  2. Moynihan R, Sanders S, Michaleff ZA, et al. Impact of COVID-19 pandemic on utilisation of healthcare services: a systematic review. BMJ Open 2021;11:e045343.
  3. Zhang J. Hospital avoidance and unintended deaths during the COVID-19 pandemic. American Journal of Health Economics 2021;7:405-426. https://doi.org/10.1086/715158
  4. Santoli JM. Effects of the COVID-19 pandemic on routine pediatric vaccine ordering and administration-United States, 2020. MMWR Morbidity and Mortality Weekly Report 2020;69
  5. Roberton T, Carter ED, Chou VB, Stegmuller AR, Jackson BD, Tam Y, et al. Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study. The Lancet Global Health 2020;8:e901-e908. https://doi.org/10.1016/S2214-109X(20)30229-1
  6. Kaye AD, Okeagu CN, Pham AD, Silva RA, Hurley JJ, Arron BL, et al. Economic impact of COVID-19 pandemic on healthcare facilities and systems: International perspectives. Best Practice & Research Clinical Anaesthesiology 2021;35:293-306. https://doi.org/10.1016/j.bpa.2020.11.009
  7. Boserup B, McKenney M, Elkbuli A. The financial strain placed on America's hospitals in the wake of the COVID-19 pandemic. The American Journal of Emergency Medicine 2021;45:530-531. https://doi.org/10.1016/j.ajem.2020.07.007
  8. Lee M, You M. Avoidance of healthcare utilization in South Korea during the coronavirus disease 2019 (COVID-19) pandemic. International Journal of Environmental Research and Public Health 2021;18:4363.
  9. Splinter MJ, Velek P, Ikram MK, Kieboom BCT, Peeters RP, Bindels PJE, et al. Prevalence and determinants of healthcare avoidance during the COVID-19 pandemic: a population-based cross-sectional study. PLoS Medicine 2021;18:e1003854.
  10. Czeisler ME, Marynak K, Clarke KEN, Salah Z, Shakya I, Thierry JM, et al. Delay or avoidance of medical care because of COVID-19-related concerns-United States, June 2020. Morbidity and mortality weekly report 2020;69:1250.
  11. Hung KK, Walline JH, Chan EYY, Huang Z, Lo ESK, Yeoh EK, et al. Health service utilization in Hong Kong during the COVID-19 pandemic-a cross-sectional public survey. International Journal of Health Policy and Management 2022;11:508-513.
  12. Arnetz BB, Goetz C, vanSchagen J, Baer W, Smith S, Arnetz JE. Patient-reported factors associated with avoidance of in-person care during the COVID-19 pandemic: results from a national survey. PLoS One 2022;17:e0272609.
  13. Doyle C, Lennox L, Bell D. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open 2013;3:e001570.
  14. Reeves R, Seccombe I. Do patient surveys work? The influence of a national survey programme on local quality-improvement initiatives. BMJ Quality & Safety 2008;17:437-441. https://doi.org/10.1136/qshc.2007.022749
  15. Lau JT, Griffiths S, Choi KC, Tsui HY. Avoidance behaviors and negative psychological responses in the general population in the initial stage of the H1N1 pandemic in Hong Kong. BMC Infectious Diseases 2010;10:1-13. https://doi.org/10.1186/1471-2334-10-1
  16. Lau J, Yang X, Tsui H, Kim J. Monitoring community responses to the SARS epidemic in Hong Kong: from day 10 to day 62. Journal of Epidemiology & Community Health 2003;57:864-870. https://doi.org/10.1136/jech.57.11.864
  17. Lee KD, Lee SB, Lim JK, Kang YM, Kim IB, Moon HJ, et al. Providing essential clinical care for non-COVID-19 patients in a Seoul metropolitan acute care hospital amidst ongoing treatment of COVID-19 patients. Journal of Hospital Infection 2020;106:673-677. https://doi.org/10.1016/j.jhin.2020.09.031
  18. Oh J, Cho S, Choi J. Changes in healthcare utilization during the COVID-19 pandemic. Journal of Health Administration 2021;31:508-517.
  19. Metin A, Erbicer ES, Sen S, Cetinkaya A. Gender and COVID-19 related fear and anxiety: a meta-analysis. Journal of Affective Disorders 2022;310:384-395. https://doi.org/10.1016/j.jad.2022.05.036
  20. Jiyoung Thak JL. "Came for testing but anxious about getting infected" hesitates outside the screening center. The Kyunghyang Shinmun: The Kyunghyang Shinmun;2020.
  21. Einav S, Tankel J. The unseen pandemic: treatment delays and loss to follow-up due to fear of COVID. Journal of Anesthesia, Analgesia and Critical Care 2022;2:5.
  22. Dancer SJ. Reducing the risk of COVID-19 transmission in hospitals: focus on additional infection control strategies. Surgery (Oxford) 2021;39:752-758. https://doi.org/10.1016/j.mpsur.2021.10.003
  23. Jain SH, Lucey C, Crosson FJ. The enduring importance of trust in the leadership of health care organizations. JAMA 2020;324:2363-2364. https://doi.org/10.1001/jama.2020.18555
  24. Hurwitz HM, Mercer M, Rose SL. Interventions that improve patient experience evidenced by raising HCAHPS and CG-CAHPS Scores: a narrative literature review. Patient Experience Journal 2023;10:107-114. https://doi.org/10.35680/2372-0247.1669
  25. Karalius VP, Kaskar SB, Levine DA, Darling TA, Loftus TM, McCarthy DM. Emergency department patient experiences during the COVID-19 pandemic. Journal of Patient Experience 2021;8:23743735211033752.
  26. Cornesse C, Bosnjak M. Is there an association between survey characteristics and representativeness? A Meta-Analysis 2018:1-13.