Coronavirus Disease Pandemic Effect on Medical-Seeking Behaviors Even in One Resource-Competent Community: A Case Controlled Study

Fang Wang; Jin-Ming Wu; Yi-Chieh Lin; Te-Wei Ho; Hui-Lin Lin; Hsi-Yu Yu; I-Rue Lai

doi:10.3390/ijerph191710822

Coronavirus Disease Pandemic Effect on Medical-Seeking Behaviors Even in One Resource-Competent Community: A Case Controlled Study

Int J Environ Res Public Health. 2022 Aug 30;19(17):10822. doi: 10.3390/ijerph191710822.

Authors

Fang Wang¹, Jin-Ming Wu^{2

3}, Yi-Chieh Lin⁴, Te-Wei Ho², Hui-Lin Lin¹, Hsi-Yu Yu², I-Rue Lai²

Affiliations

¹ Department of Nursing, National Taiwan University Hospital, Taipei 100, Taiwan.
² Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan.
³ Department of Surgery, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu 300, Taiwan.
⁴ Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung City 807, Taiwan.

Abstract

(1) Background: The coronavirus disease 2019 (COVID-19) pandemic had overwhelming impacts on medical services. During its initial surge, Taiwan was unique in maintaining its medical services without imposing travel restrictions, which provided an ideal environment in which to test if the fear of becoming infected with COVID-19 interfered with health-seeking behavior (HSB). We tested this hypothesis among adults with acute complicated appendicitis (ACA). (2) Methods: Adults with acute appendicitis were enrolled between 1 January and 30 June 2020 (COVID-19 period). The first two quarters of the preceding 3 years were defined as a historical control group. Outcome measures included the rate of ACA and the number of hospital stays. (3) Results: The COVID-19 era included 145 patients with acute appendicitis. Compared to the historical control (320 patients), the COVID-19 era was significantly associated with a higher length of symptom duration until presentation to the emergency room within >48 h (17.2% vs. 9.1%, p = 0.011), a higher incidence of ACA (29.7% vs. 19.4%, p = 0.014), and a longer length of hospital stays (5.0 days vs. 4.0 days, p = 0.043). The adjusted models showed that the COVID-19 period had a significant relationship with a higher rate of ACA (odds ratio (OR) = 1.87; 95% confidence interval (CI): 1.23-2.52; p = 0.008) and longer length of hospital stays (OR= 2.10; 95% CI: 0.92 to 3.31; p < 0.001). (4) Conclusions: The fear of COVID-19 may prohibit patients from seeking medical help, worsening their clinical outcomes. The surgical community should take action to provide scientific information to relive mental stress.

Keywords: COVID-19; appendicitis; health-seeking behavior; surgical care.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Acute Disease
Adult
Appendicitis* / epidemiology
COVID-19* / epidemiology
Case-Control Studies
Humans
Pandemics
Retrospective Studies
SARS-CoV-2

Grants and funding

This study was supported by a grant from NTUH (109-P22) and grants from the Ministry of Science and Technology (Numbers 110-2634-F-002-032 and 110-2811-E-002-528-MY3), Taiwan, which had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.