Impact of Covid-19 Pandemic on Health Service Utilization among Non-Communicable Disease (NCD) Patients in Ghana: An Interrupted Time Series Analysis

Abstract

Background The COVID-19 pandemic has interrupted the world's healthcare systems, causing a substantial disruption in routine healthcare services. Non-communicable Diseases (NCDs) are the leading cause of morbidity and mortality in Ghana. In Ghana, accessing care for NCDs has been difficult, especially in rural regions. This already-existing challenge has been aggravated by the COVID-19 pandemic. This study seeks to estimate the impact of the COVID-19 pandemic on the utilization of healthcare services among non-communicable disease patients in Ghana Method The study employed a retrospective longitudinal study using routine time series data on non communicable (NCD) care visits from January 2018 to December 2022. Interrupted time series analysis was used to compare the number of NCD care visits before and during the COVID-19 pandemic, and to quantify the impact of COVID-19 on NCDs of interest. Results The results are presented under two main headings. One is the immediate impact of the COVID 19 pandemic on NCD care visits and the second is the sustained impact of the pandemic on NCD care visits. The analysis showed that the COVID-19 pandemic had no immediate, and sustained impact on asthma care visits nationally. However, the pandemic had a significant immediate impact [1.22, (p-value=0.003; CI=0.45, 1.98)], and a significant sustained impact [-0.061, (p value=0.008; CI=-0.11, -0.017)] on diabetes care visits nationally. Also, hypertension care visits experienced significant immediate impacts [2.05, (p-value=0.023; CI=0.29, 3.81)] nationally. Lastly, the pandemic also had a significant sustained impact [-1.05, (p-value=0.004; CI=-1.75, 0.35)] on stroke care visits nationally. Across the sixteen administrative regions, the pandemic affected NCD care visits differently. NCD care visits in some regions were significantly interrupted while in other regions there was no significant impact. Conclusion The study has provided evidence of some significant immediate and sustained effect of the COVID-19 outbreak on most Non-Communicable Disease (NCD) care visits in Ghana. The findings underscore the need for policymakers and health practitioners to prioritize NCD care during pandemics and develop innovative strategies to mitigate the impact