The impact of COVID-19 restrictions on pathology service utilisation.

Gillam, Marianne H; Roughead, Elizabeth; Tavella, Rosanna; Dodd, Tom; Beltrame, John; Ryan, Richard; O'Loughlin, Peter

BACKGROUND Isolation and social distancing restrictions due to COVID-19 have the potential to impact access to health care services. AIMS To assess the use of pathology services during the COVID-19 pandemic initial restrictions. METHODS Repeated cross-sectional study of pathology tests utilisation during a baseline time period early in 2020 compared to pre-lockdown and lockdown due to COVID-19 in South Australia. The outcome measure was change in number of pathology tests compared to baseline period, particularly change in the number of troponin tests to determine potential impacts of lockdown on urgent care presentations. RESULTS In the community setting the ratio of number of pathology tests pre-lockdown and post-lockdown vs. baseline period decreased from 1.02 to 0.53 respectively. The exception was microbiology molecular tests, where the number of tests was more than 3 times higher in the lockdown period. The number of troponin tests in emergency departments decreased in the lockdown period compared to the baseline time period, however, there was no evidence of an association between tests result (positive vs negative) and time period (OR 1.09 95% CI 0.97-1.22). There was an inverse relationship between age and time period (OR 0.995, 95%CI 0.993-0.997), indicating that fewer troponin tests were conducted in older people during the lockdown compared to the baseline period. CONCLUSION COVID-19 restrictions had a significant impact on the use of pathology testing in both urgent and non-urgent care settings. Further studies are needed to investigate the effect on health outcomes as a result of the COVID-19 restrictions. This article is protected by copyright. All rights reserved.