Decline in Healthcare Services during COVID-19 in the United Kingdom.

Abstract

There are growing concerns that the COVID-19 pandemic could have an adverse impact on the health care sector, an industry that has historically been shielded from the business cycle. In this thesis, we study one aspect of this issue by estimating the magnitude of the COVID-19 pandemic's impact on the use of outpatient health services in the UK. We use 2017–2020 data from the United Kingdom National Health Service’s (NHS) Monthly Activity Return (MAR) and survey waves 1–6 of the COVID-19 web survey released by the Understanding Society Longitudinal Study. Our findings indicate that the COVID-19 pandemic is associated with a sharp decline of 74% in the total number of outpatient visits per provider by April 2020, relative to the same month in prior years. Our results were consistent across all commissioning regions of the NHS. We also studied the mechanisms involved in this decline and determined that the drivers depended on the type of NHS service but were largely supply-related for outpatient and inpatient services. Finally, we assessed inequality in access to healthcare in April 2020 among patients with long-term health conditions, based on their age, gender, ethnicity, and disease type.

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