Determinants of Healthcare Utilisation Among Post-COVID Syndrome Patients: A Population-Based Study in Malaysia
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Post-COVID syndrome (PCS) occurs three months after the initial onset of COVID-19 without an alternative diagnosis. The exponential PCS case growth has significantly influenced healthcare utilisation. This study aimed to determine the factors associated with healthcare utilisation among post-COVID syndrome (PCS) patients in Selangor, Malaysia. A cross-sectional study was conducted from August 2023 and November 2023 at the Hospital Sungai Buloh COVID-19 Rehabilitation Outpatient Specialised Services (CROSS) Centre. Eligible participants were adults (≥ 18 years old) who had been followed up due to ongoing COVID-19 symptoms beyond 12 weeks from the acute illness before data collection began. Universal sampling was applied. The proportion of the reported data on socio-demographics, health status, PCS symptoms, health-related quality of life (HRQoL) (EQ-5D-5L), and mental health status (DASS-21) was assessed. The factors associated with healthcare utilisation were evaluated using a multiple regression model. Of 220 patients, 58.6% were male. The mean (standard deviation [SD]) patient age was 53.04 (12.87) years, and 64.5% of the patients were Malay. Overall, the patients’ mean (SD) EQ-5D-5L index, and EQ-VAS scores were 0.90 (0.143) and 78.25 (9.905), respectively. The depression, anxiety, and stress mean scores were categorised as normal. The mean (SD) number of outpatient clinic visits was 3.26 (1.24). The multivariable model indicated statistically significant effects of the current vaccine doses (β = 0.121; p = 0.049), history of hospitalisation (β = 0.156; p = 0.012), history of intensive care unit (ICU) admission (β = 0.275; p < 0.001), chest pain (β = 0.137; p = 0.029), and EQ-VAS score (β = -0.257; p = 0.012) on increased healthcare utilisation. These results could be used as a model for implementing future healthcare management and programs related to PCS to provide Malaysian patients with proper support.
