Trends of Follow-Up Clinic Visits and Admissions Three-Months Before and During COVID-19 Pandemic at Tikur Anbessa Specialized Hospital, Ethiopia: an Interrupted Time Series Analysis

Abebe, Workeabeba Worku Alemayehu Moges Tamirat Tekle Nuhamin Amogne Wondowossen Haile Tewodros Mekonen Desalew Habtamu Abebe Deressa Wakgari

Background: Following the first report of the COVID-19 case in Ethiopia on the 13th of March 2020, the country adopted a lockdown policy to contain the spread of the virus. Responding to the health-care burden imposed by the COVID-19 pandemic had to be coupled with ensuring essential health care services. This study assessed the impact of COVID-19 on the trends of non-COVID follow-up visits and admissions at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods: A retrospective, time-series study with the 1st case of COVID-19 report as a reference time examined the trend in follow-up visits and admissions between December 1st, 2019 and May 31st, 2020. A comparison of health care utilization between December 2019 to May 2020 and its equivalent period in 2018/19 was also done. A data abstraction tool was used to collect secondary data from the hospital’s electronic medical recordings and logbooks of each unit. Results: A total of 7,717 visits from eight follow-up clinics and 3,310 admissions were collected during three months before the onset of COVID-19. During the following three months after the pandemic, 4,597 visits and 2,383 admissions were collected. Overall, a 40.4% decrease in follow-up visits and a 28% decline in admissions were observed during the COVID-19. The drop in the daily follow-up visits was observed for both genders. The number of visits in all follow-up clinics in 2019/2020 decreased when compared to the same months in 2018/19(p<0.05). Follow-up visits were substantially lower for renal patients (-68%), patients with neurologic problems (−53.9%), antiretroviral treatment clinics (−52.3%), cardiac patients (−51.4%). Although pediatric emergency admission was significantly lower (−54.1%) from the baseline (p=0.04), admissions from the general pediatric and adult wards did not show a significant difference. Conclusions: Significant decreases in-hospital follow-up clinic visits were observed during the first months of the COVID-19 pandemic. Public health guidance on how best to access care, more for patients with serious illnesses are required. Promoting self-care, alternatives health-care services like home-based care, and phone clinics might be considered for patients with mild symptoms. Further studies needed to track the long-term effect of the pandemic among non-COVID-19 patients.