Introduction: During a pandemic, it is essential to have timely and effective responses to rapidly monitor its impact on the healthcare system. The system of data collection, analysis, and feedback was reconstructed for this purpose. Methods: To rapidly measure the COVID-19 impact, a sub-project was launched early in 2020 as part of the Quality Indicator/Improvement Project (QIP), to which over 500 hospitals were voluntarily registered from across the nation. In normal times, the anonymous individual-level data of all the patients of participating hospitals were routinely collected and securely stored in the QIP database securely managed. Under the COVID-19 pandemic, QIP was converted into an emergency mode, which enabled a more rapid assessment of the healthcare system. Statistical methods used included interrupted time-series analysis adjusted for seasonality and time trends. Results: During the pandemic, inpatient visits were reduced in almost all areas, including stroke, myocardial infarction, heart failure, pneumonia, insufficiency fractures, and even cancer surgeries, except for alcohol-induced diseases. Furthermore, the number of inpatients and outpatients did not recover even after the pandemic was over, which showed an increasingly difficult environment for healthcare management. Hospital reimbursement income dropped dramatically, by as much as 30% in the first half of the year compared to the previous year, particularly in hospitals that treated more COVID-19 inpatients. This alerted an urgent need for subsidies to sustain the healthcare system. Evidence suggested that the quality of care was maintained in medical and surgical fields such as acute myocardial infarction and insufficiency fractures, even under a stressful working environment during the pandemic. Conclusion: The system developed in this project demonstrated a prototype that could potentially be implemented at the national level to rapidly monitor the impacts of pandemics on healthcare systems, enabling policymakers and healthcare administrators to respond more effectively and timely.
Imanaka et al. (Sun,) studied this question.