Healthcare Access and Utilization During the COVID-19 Pandemic

The COVID-19 pandemic precipitated unprecedented disruptions to health systems globally, causing widespread reductions in routine and emergency care. Lockdowns and infection control measures led to sharp declines in in-person consultations, diagnostic testing and elective procedures. To maintain service delivery, many providers rapidly scaled telehealth and digital health platforms, mitigating some barriers but exposing disparities in digital access. Vulnerable populations—older adults, ethnic minorities and socioeconomically disadvantaged groups—often experienced larger declines in service use and slower recovery. Geographical variation was marked: countries with robust primary care networks saw quicker rebounds, whereas those with fragmented systems faced prolonged interruptions. As the acute phase subsided, most settings reported gradual recovery towards pre-pandemic levels, though certain services (mental health, chronic disease management and preventive screenings) remained below historical norms. Lessons from this period are reshaping future health-system resilience, emphasising flexible service models, strengthened public-health infrastructure and equity-centred planning.

Research from Nature Portfolio

Recent analyses of provincial health information systems in China during the Shanghai Omicron outbreak reveal profound service disruptions. During March–May 2022, outpatient visits in Shanghai fell by nearly half and inpatient discharges by over 50 %, with smaller but still significant losses in other provinces. An interrupted time series approach linked greater reductions in patient movement—used as a proxy for lockdown stringency—to steeper declines in both outpatient and inpatient volumes. These findings demonstrate a clear quantitative relationship between the intensity of containment measures and reductions in healthcare utilisation, underscoring the trade-offs between infection control and access to routine and urgent care.

Healthcare Access and Utilization During the COVID-19 Pandemic publication trend

The graph below shows the total number of articles in healthcare access and utilization during the covid-19 pandemic across all publications each year (not limited to Nature Index journals).

Technical terms

Healthcare utilisation: The frequency with which health services are used by a population, encompassing outpatient visits, inpatient admissions and telehealth consultations.

Telehealth: The delivery of health-related services and information via telecommunications technologies, including video consultations and remote monitoring.

Interrupted time series analysis: A statistical method for evaluating the impact of an intervention or event by analysing outcome trends before and after its occurrence.

Primary care: The first point of contact in the health system, providing accessible, continuous, comprehensive and coordinated care for individuals and families.

References

1. Dynamic zero-COVID policy and healthcare utilization patterns in China during the Shanghai COVID-19 Omicron outbreak. Communications Medicine (2023).
2. The road to recovery: impact of COVID-19 on healthcare utilization in South Korea in 2016–2022 using an interrupted time-series analysis. The Lancet Regional Health - Western Pacific (2023).
3. Indirect acute effects of the COVID-19 pandemic on physical and mental health in the UK: a population-based study. The Lancet Digital Health (2021).
4. Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020. MMWR Morbidity and Mortality Weekly Report (2020).
5. Changes in Access to Health Services during the COVID-19 Pandemic: A Scoping Review. International Journal of Environmental Research and Public Health (2022).