The Impact of COVID-19 outbreak on the use of equity fund services among the poor who received health care at referral hospitals in Kratie province

Keywords

Health equity fund
Referral hospital
Covid-19
Utilization of services
Hospitalization
Kratie province

Abstract

Introduction

Universal health coverage (UHC) is based on the principle that all individuals and communities have access to essential quality health services when they need them without financial hardship. The Equity Fund project is part of Cambodia's social protection system for the poor. The first case of COVID-19 was discovered in Cambodia in Sihanoukville on January 27, 2020. By the end of 2021, the infection rate had reached 120,507, with deaths from the disease rising to 3,012 across Cambodia. This study aimed to describe the impact of the COVID-19 outbreak on the use of equity fund services at three referral hospitals of the Kratie Provincial Health Department.

Methods

This was a study using retrospective data from the poor patients of the Equity Fund project extracted from the PMRS system and the data from the general patients in the three referral hospitals of the Kratie Provincial Health Department extracted from the Health Information System. The impact of the COVID-19 epidemic on the use of equity fund services was determined by comparing the use of services among the poor and the general population before and during the COVID-19 epidemic. ANOVA and the chi-square test were used for comparison purposes.

Results

The total utilization of services by the poor as well as the general population prior to the outbreak of COVID-19 (2019) and during the outbreak of COVID-19 (2020-2021) has changed little, with no significant difference. However, types of service use showed that the number of hospitalizations among the poor decreased significantly between 2019 (on average, 741 cases/month) and 2021 (on average, 446 cases/month), p value < 0.05, while the number of hospitalizations for the general population did not change significantly in the same period. There were no significant changes in the general characteristics of patients who came to the service before and during the outbreak of COVID-19.

Conclusion

The findings of this study show that the spread of COVID-19 has little effect on the use of equity funds among the poor who come to the three referral hospitals of the Kratie Provincial Health Department, especially hospitalization services.