The Impact of the SARS Epidemic on the Utilization of Medical Services: SARS and the Fear of SARS
Identifieur interne : 001451 ( Pmc/Checkpoint ); précédent : 001450; suivant : 001452The Impact of the SARS Epidemic on the Utilization of Medical Services: SARS and the Fear of SARS
Auteurs : Hong-Jen Chang [Taïwan] ; Nicole Huang [Taïwan] ; Cheng-Hua Lee [Taïwan] ; Yea-Jen Hsu [Taïwan] ; Chi-Jeng Hsieh [Taïwan] ; Yiing-Jenq Chou [Taïwan]Source :
- American Journal of Public Health [ 0090-0036 ] ; 2004.
Abstract
Using interrupted time-series analysis and National Health Insurance data between January 2000 and August 2003, this study assessed the impacts of the severe acute respiratory syndrome (SARS) epidemic on medical service utilization in Taiwan. At the peak of the SARS epidemic, significant reductions in ambulatory care (23.9%), inpatient care (35.2%), and dental care (16.7%) were observed. People’s fears of SARS appear to have had strong impacts on access to care. Adverse health outcomes resulting from accessibility barriers posed by the fear of SARS should not be overlooked.
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PubMed: 15054005
PubMed Central: 1448298
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Nicole Huang is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. Yea-Jen Hsu and Yiing-Jenq Chou are with the Department of Social Medicine, School of Medicine, National Yang Ming University, Taipei</wicri:regionArea><wicri:noRegion>Taipei</wicri:noRegion></affiliation></author><author><name sortKey="Huang, Nicole" sort="Huang, Nicole" uniqKey="Huang N" first="Nicole" last="Huang">Nicole Huang</name><affiliation wicri:level="1"><nlm:aff id="aff1">Hong-Je Chang, Cheng-Hua Lee, and Chi-Jeng Hsieh are with the Bureau of National Health Insurance, Taipei, Taiwan. Nicole Huang is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. Yea-Jen Hsu and Yiing-Jenq Chou are with the Department of Social Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Taïwan</country><wicri:regionArea>Hong-Je Chang, Cheng-Hua Lee, and Chi-Jeng Hsieh are with the Bureau of National Health Insurance, Taipei, Taiwan. Nicole Huang is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. Yea-Jen Hsu and Yiing-Jenq Chou are with the Department of Social Medicine, School of Medicine, National Yang Ming University, Taipei</wicri:regionArea><wicri:noRegion>Taipei</wicri:noRegion></affiliation></author><author><name sortKey="Lee, Cheng Hua" sort="Lee, Cheng Hua" uniqKey="Lee C" first="Cheng-Hua" last="Lee">Cheng-Hua Lee</name><affiliation wicri:level="1"><nlm:aff id="aff1">Hong-Je Chang, Cheng-Hua Lee, and Chi-Jeng Hsieh are with the Bureau of National Health Insurance, Taipei, Taiwan. Nicole Huang is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. Yea-Jen Hsu and Yiing-Jenq Chou are with the Department of Social Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Taïwan</country><wicri:regionArea>Hong-Je Chang, Cheng-Hua Lee, and Chi-Jeng Hsieh are with the Bureau of National Health Insurance, Taipei, Taiwan. Nicole Huang is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. Yea-Jen Hsu and Yiing-Jenq Chou are with the Department of Social Medicine, School of Medicine, National Yang Ming University, Taipei</wicri:regionArea><wicri:noRegion>Taipei</wicri:noRegion></affiliation></author><author><name sortKey="Hsu, Yea Jen" sort="Hsu, Yea Jen" uniqKey="Hsu Y" first="Yea-Jen" last="Hsu">Yea-Jen Hsu</name><affiliation wicri:level="1"><nlm:aff id="aff1">Hong-Je Chang, Cheng-Hua Lee, and Chi-Jeng Hsieh are with the Bureau of National Health Insurance, Taipei, Taiwan. Nicole Huang is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. Yea-Jen Hsu and Yiing-Jenq Chou are with the Department of Social Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Taïwan</country><wicri:regionArea>Hong-Je Chang, Cheng-Hua Lee, and Chi-Jeng Hsieh are with the Bureau of National Health Insurance, Taipei, Taiwan. Nicole Huang is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. Yea-Jen Hsu and Yiing-Jenq Chou are with the Department of Social Medicine, School of Medicine, National Yang Ming University, Taipei</wicri:regionArea><wicri:noRegion>Taipei</wicri:noRegion></affiliation></author><author><name sortKey="Hsieh, Chi Jeng" sort="Hsieh, Chi Jeng" uniqKey="Hsieh C" first="Chi-Jeng" last="Hsieh">Chi-Jeng Hsieh</name><affiliation wicri:level="1"><nlm:aff id="aff1">Hong-Je Chang, Cheng-Hua Lee, and Chi-Jeng Hsieh are with the Bureau of National Health Insurance, Taipei, Taiwan. Nicole Huang is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. Yea-Jen Hsu and Yiing-Jenq Chou are with the Department of Social Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Taïwan</country><wicri:regionArea>Hong-Je Chang, Cheng-Hua Lee, and Chi-Jeng Hsieh are with the Bureau of National Health Insurance, Taipei, Taiwan. Nicole Huang is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. Yea-Jen Hsu and Yiing-Jenq Chou are with the Department of Social Medicine, School of Medicine, National Yang Ming University, Taipei</wicri:regionArea><wicri:noRegion>Taipei</wicri:noRegion></affiliation></author><author><name sortKey="Chou, Yiing Jenq" sort="Chou, Yiing Jenq" uniqKey="Chou Y" first="Yiing-Jenq" last="Chou">Yiing-Jenq Chou</name><affiliation wicri:level="1"><nlm:aff id="aff1">Hong-Je Chang, Cheng-Hua Lee, and Chi-Jeng Hsieh are with the Bureau of National Health Insurance, Taipei, Taiwan. 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Nicole Huang is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. Yea-Jen Hsu and Yiing-Jenq Chou are with the Department of Social Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Taïwan</country><wicri:regionArea>Hong-Je Chang, Cheng-Hua Lee, and Chi-Jeng Hsieh are with the Bureau of National Health Insurance, Taipei, Taiwan. Nicole Huang is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. Yea-Jen Hsu and Yiing-Jenq Chou are with the Department of Social Medicine, School of Medicine, National Yang Ming University, Taipei</wicri:regionArea><wicri:noRegion>Taipei</wicri:noRegion></affiliation></author><author><name sortKey="Huang, Nicole" sort="Huang, Nicole" uniqKey="Huang N" first="Nicole" last="Huang">Nicole Huang</name><affiliation wicri:level="1"><nlm:aff id="aff1">Hong-Je Chang, Cheng-Hua Lee, and Chi-Jeng Hsieh are with the Bureau of National Health Insurance, Taipei, Taiwan. Nicole Huang is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. Yea-Jen Hsu and Yiing-Jenq Chou are with the Department of Social Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Taïwan</country><wicri:regionArea>Hong-Je Chang, Cheng-Hua Lee, and Chi-Jeng Hsieh are with the Bureau of National Health Insurance, Taipei, Taiwan. Nicole Huang is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. Yea-Jen Hsu and Yiing-Jenq Chou are with the Department of Social Medicine, School of Medicine, National Yang Ming University, Taipei</wicri:regionArea><wicri:noRegion>Taipei</wicri:noRegion></affiliation></author><author><name sortKey="Lee, Cheng Hua" sort="Lee, Cheng Hua" uniqKey="Lee C" first="Cheng-Hua" last="Lee">Cheng-Hua Lee</name><affiliation wicri:level="1"><nlm:aff id="aff1">Hong-Je Chang, Cheng-Hua Lee, and Chi-Jeng Hsieh are with the Bureau of National Health Insurance, Taipei, Taiwan. Nicole Huang is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. Yea-Jen Hsu and Yiing-Jenq Chou are with the Department of Social Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Taïwan</country><wicri:regionArea>Hong-Je Chang, Cheng-Hua Lee, and Chi-Jeng Hsieh are with the Bureau of National Health Insurance, Taipei, Taiwan. Nicole Huang is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. Yea-Jen Hsu and Yiing-Jenq Chou are with the Department of Social Medicine, School of Medicine, National Yang Ming University, Taipei</wicri:regionArea><wicri:noRegion>Taipei</wicri:noRegion></affiliation></author><author><name sortKey="Hsu, Yea Jen" sort="Hsu, Yea Jen" uniqKey="Hsu Y" first="Yea-Jen" last="Hsu">Yea-Jen Hsu</name><affiliation wicri:level="1"><nlm:aff id="aff1">Hong-Je Chang, Cheng-Hua Lee, and Chi-Jeng Hsieh are with the Bureau of National Health Insurance, Taipei, Taiwan. Nicole Huang is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. Yea-Jen Hsu and Yiing-Jenq Chou are with the Department of Social Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Taïwan</country><wicri:regionArea>Hong-Je Chang, Cheng-Hua Lee, and Chi-Jeng Hsieh are with the Bureau of National Health Insurance, Taipei, Taiwan. Nicole Huang is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. Yea-Jen Hsu and Yiing-Jenq Chou are with the Department of Social Medicine, School of Medicine, National Yang Ming University, Taipei</wicri:regionArea><wicri:noRegion>Taipei</wicri:noRegion></affiliation></author><author><name sortKey="Hsieh, Chi Jeng" sort="Hsieh, Chi Jeng" uniqKey="Hsieh C" first="Chi-Jeng" last="Hsieh">Chi-Jeng Hsieh</name><affiliation wicri:level="1"><nlm:aff id="aff1">Hong-Je Chang, Cheng-Hua Lee, and Chi-Jeng Hsieh are with the Bureau of National Health Insurance, Taipei, Taiwan. Nicole Huang is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. Yea-Jen Hsu and Yiing-Jenq Chou are with the Department of Social Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Taïwan</country><wicri:regionArea>Hong-Je Chang, Cheng-Hua Lee, and Chi-Jeng Hsieh are with the Bureau of National Health Insurance, Taipei, Taiwan. Nicole Huang is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. Yea-Jen Hsu and Yiing-Jenq Chou are with the Department of Social Medicine, School of Medicine, National Yang Ming University, Taipei</wicri:regionArea><wicri:noRegion>Taipei</wicri:noRegion></affiliation></author><author><name sortKey="Chou, Yiing Jenq" sort="Chou, Yiing Jenq" uniqKey="Chou Y" first="Yiing-Jenq" last="Chou">Yiing-Jenq Chou</name><affiliation wicri:level="1"><nlm:aff id="aff1">Hong-Je Chang, Cheng-Hua Lee, and Chi-Jeng Hsieh are with the Bureau of National Health Insurance, Taipei, Taiwan. Nicole Huang is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. Yea-Jen Hsu and Yiing-Jenq Chou are with the Department of Social Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Taïwan</country><wicri:regionArea>Hong-Je Chang, Cheng-Hua Lee, and Chi-Jeng Hsieh are with the Bureau of National Health Insurance, Taipei, Taiwan. Nicole Huang is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. Yea-Jen Hsu and Yiing-Jenq Chou are with the Department of Social Medicine, School of Medicine, National Yang Ming University, Taipei</wicri:regionArea><wicri:noRegion>Taipei</wicri:noRegion></affiliation></author></analytic><series><title level="j">American Journal of Public Health</title><idno type="ISSN">0090-0036</idno><idno type="eISSN">1541-0048</idno><imprint><date when="2004">2004</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Using interrupted time-series analysis and National Health Insurance data between January 2000 and August 2003, this study assessed the impacts of the severe acute respiratory syndrome (SARS) epidemic on medical service utilization in Taiwan. At the peak of the SARS epidemic, significant reductions in ambulatory care (23.9%), inpatient care (35.2%), and dental care (16.7%) were observed. People’s fears of SARS appear to have had strong impacts on access to care. Adverse health outcomes resulting from accessibility barriers posed by the fear of SARS should not be overlooked.</p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Am J Public Health</journal-id><journal-id journal-id-type="publisher-id">ajph</journal-id><journal-title>American Journal of Public Health</journal-title><issn pub-type="ppub">0090-0036</issn><issn pub-type="epub">1541-0048</issn><publisher><publisher-name>© American Journal of Public Health 2004</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">15054005</article-id><article-id pub-id-type="pmc">1448298</article-id><article-id pub-id-type="publisher-id">0940562</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research and Practice</subject></subj-group></article-categories><title-group><article-title>The Impact of the SARS Epidemic on the Utilization of Medical Services: SARS and the Fear of SARS</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Chang</surname><given-names>Hong-Jen</given-names></name><degrees>MD, MPH</degrees><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Huang</surname><given-names>Nicole</given-names></name><degrees>MPH</degrees><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Lee</surname><given-names>Cheng-Hua</given-names></name><degrees>MD, DrPH</degrees><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Hsu</surname><given-names>Yea-Jen</given-names></name><degrees>MS</degrees><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Hsieh</surname><given-names>Chi-Jeng</given-names></name><degrees>MS</degrees><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Chou</surname><given-names>Yiing-Jenq</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="aff1"></xref></contrib></contrib-group><aff id="aff1">Hong-Je Chang, Cheng-Hua Lee, and Chi-Jeng Hsieh are with the Bureau of National Health Insurance, Taipei, Taiwan. Nicole Huang is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. Yea-Jen Hsu and Yiing-Jenq Chou are with the Department of Social Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan.</aff><author-notes><fn><p><italic>Requests for reprints should be sent to Hong-Jen Chang, 140, Sec 3, Hsin-Yi Rd, Taipei, Taiwan 106 (e-mail: <email>hjchang@mail.nhi.gov.tw</email>).</italic></p></fn></author-notes><pub-date pub-type="ppub"><month>4</month><year>2004</year></pub-date><volume>94</volume><issue>4</issue><fpage>562</fpage><lpage>564</lpage><history><date date-type="accepted"><day>30</day><month>11</month><year>2003</year></date></history><copyright-statement>© American Journal of Public Health 2004</copyright-statement><copyright-year>2004</copyright-year><abstract><p>Using interrupted time-series analysis and National Health Insurance data between January 2000 and August 2003, this study assessed the impacts of the severe acute respiratory syndrome (SARS) epidemic on medical service utilization in Taiwan. At the peak of the SARS epidemic, significant reductions in ambulatory care (23.9%), inpatient care (35.2%), and dental care (16.7%) were observed. People’s fears of SARS appear to have had strong impacts on access to care. Adverse health outcomes resulting from accessibility barriers posed by the fear of SARS should not be overlooked.</p></abstract></article-meta><notes><fn-group><fn><p><bold>Contributors</bold>
H. J. Chang planned the study and supervised all aspects of its implementation. N. Huang assisted with the study and led the writing. C. H. Lee synthesized analyses and contributed to the writing of the article. C. J. Hsieh assisted with the data management and the study. Y. J. Hsu assisted with the study and analyses. Y. J. Chou planned the study, completed the statistical analysis, and supervised the study implementation. All authors helped to conceptualize ideas, interpret findings, and review drafts of the brief.</p></fn><fn><p>Peer Reviewed</p></fn></fn-group></notes></front></pmc><affiliations><list><country><li>Taïwan</li></country></list><tree><country name="Taïwan"><noRegion><name sortKey="Chang, Hong Jen" sort="Chang, Hong Jen" uniqKey="Chang H" first="Hong-Jen" last="Chang">Hong-Jen Chang</name></noRegion><name sortKey="Chou, Yiing Jenq" sort="Chou, Yiing Jenq" uniqKey="Chou Y" first="Yiing-Jenq" last="Chou">Yiing-Jenq Chou</name><name sortKey="Hsieh, Chi Jeng" sort="Hsieh, Chi Jeng" uniqKey="Hsieh C" first="Chi-Jeng" last="Hsieh">Chi-Jeng Hsieh</name><name sortKey="Hsu, Yea Jen" sort="Hsu, Yea Jen" uniqKey="Hsu Y" first="Yea-Jen" last="Hsu">Yea-Jen Hsu</name><name sortKey="Huang, Nicole" sort="Huang, Nicole" uniqKey="Huang N" first="Nicole" last="Huang">Nicole Huang</name><name sortKey="Lee, Cheng Hua" sort="Lee, Cheng Hua" uniqKey="Lee C" first="Cheng-Hua" last="Lee">Cheng-Hua Lee</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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