本研究旨在评估COVID-19大流行对全科医生(GP)的影响,专家,社会保障组织(SSO)覆盖的4000万伊朗人中的牙医访问。在72个月的时间内进行了每月中断的时间序列分析,包括大流行前47个月和大流行后25个月。结果变量为每月GP人数,专家,和每1000名SSO保险的个人看牙医。分析按总访视进行,访问SSO直接部门,以及对间接部门的访问。研究发现,在大流行的第一个月,每1000名被保险人访问全科医生的访问次数显着下降(51.12,95%CI-64.42至-37.88),访问专家(由39.11,95%CI-51.61至-26.62),和看牙医(6.67,95%CI-8.55至-4.78)。然而,在大流行的随后几个月中,所有三个类别的每月访问次数均显着增加,全科医生的增幅最高(每1000名被保险人中有1.78次就诊),其次是专家(每1000名被保险人访问1.32次),和牙医(每1000名被保险人0.05次就诊)。此外,在大流行之前,与直接部门相比,间接部门每1000名受保个人的每月全科医生就诊次数在统计学上显著较低(45.79,95%CI-52.69~-38.89).相反,直接部门的专家访视率较低(每1000名被保险人中有25.84次访视,95%CI22.87至28.82)和牙医就诊(每1000名被保险人0.75次,95%CI0.12至1.36)与间接部门相比。此外,研究发现,在大流行的第一个月,与直接部门相比,间接部门的每月全科医生就诊次数显着增加了34.44倍(95%CI24.81至44.08)。对于专家访问和牙医访问,每1000名被保险人增加3.41(95%CI-5.87至12.69)和5.01(95%CI3.48至6.53),分别。总的来说,这项研究的结果表明,GP在统计学上有显著的中断,专家,在COVID-19大流行期间看牙医,尽管观察到了一些恢复。直接和间接部门的访问量都有所减少。
This study aimed to assess the impact of the COVID-19 pandemic on general practitioner (GP), specialist, and
dentist visits among 40 million Iranians covered by the Social Security Organization (SSO). A monthly interrupted time series analysis was conducted over a period of 72 months, including-47 months before the pandemic and 25 months after its onset. The outcomes variables were monthly number of GP, specialist, and
dentist visits per 1000 SSO-insured individuals. The analysis was performed by total visits, visits to the SSO direct sector, and visits to the indirect sectors. The study found that in the first month of the pandemic, the number of visits per 1000 insured individuals significantly decreased for visits to GPs (by 51.12, 95% CI -64.42 to -37.88), visits to specialists (by 39.11, 95% CI -51.61 to -26.62), and visits to dentists (by 6.67, 95% CI -8.55 to -4.78). However, during the subsequent months of the pandemic, there was a significant increase in the number of monthly visits for all three categories, with GPs experiencing the highest increase (1.78 visits per 1000 insured), followed by specialists (1.32 visits per 1000 insured), and dentists (0.05 visits per 1000 insured). Furthermore, prior to the pandemic, the number of monthly GP visits per 1000 insured individuals was statistically significantly lower in the indirect sector compared to the direct sector (45.79, 95% CI -52.69 to -38.89). Conversely, the direct sector exhibited lower rates of specialist visits (25.84 visits per 1000 insured individuals, 95% CI 22.87 to 28.82) and
dentist visits (0.75 visits per 1000 insured individuals, 95% CI 0.12 to 1.36) compared to the indirect sector. Additionally, the study found that in the first month of the pandemic, the monthly number of GP visits in the indirect sector significantly increased by 34.44 times (95% CI 24.81 to 44.08) compared to the direct sector. For specialist visits and
dentist visits, the increase was 3.41 (95% CI -5.87 to 12.69) and 5.01 (95% CI 3.48 to 6.53) per 1000 insured individuals, respectively. Overall, the findings of this study demonstrate statistically significant disruptions in GP, specialist, and
dentist visits during the COVID-19 pandemic, although some recovery was observed. Both the direct and indirect sectors experienced decreased visits.