The impact of the COVID-19 pandemic on governmental hospitals performance indicators in city of Yazd, Iran: an interrupted time-series analysis.

Abstract

Background: The Covid-19 pandemic stretched health systems globally including in Iran. Hospital demand and performance was affected both directly and indirectly as a result of the pandemic. Analyzing hospital indicators can provide insights to deal with the consequences and challenges related to various aspects of future pandemics.

Objective: This study aimed to investigate the impact of the Covid-19 pandemic on key performance indicators of public hospitals in Iran.

Methods: In this quasi-experimental study, we used time-series analysis to examine eight key indicators of hospital performance: number of outpatient visits, number of elective hospitalization, average length of stay, hospital mortality rate, number of surgeries, hospitalization rate, emergency visits, bed occupancy rate, and hospitals' revenue. Data were extracted from four public hospitals in Yazd at two time intervals, 15 months before and after the outbreak of COVID-19. Data were analysed using interrupted time series analysis models with STATA₁₇.

Results: Average length of stay (p = 0.02) and hospital mortality rate (p < 0.01) increased significantly following the outbreak of COVID-19, while the mean of other indicators such as number of outpatient visits (p < 0.01), number of elective hospitalization (p < 0.01), number of surgeries (p = 0.01), hospitalization rate (p < 0.01), emergency visits (p < 0.01) and bed occupancy rate (p < 0.01) decreased significantly. The Covid-19 pandemic had an immediately reverse significant impact on the level changes of "outpatient visits", "elective hospitalization", "hospitalization rate", "emergency visits" and "bed occupancy rate" indicators (p < 0.05). Although the trend of surgeries indicator was affected significantly (p = 0.01) after the covid-19 outbreak.

Conclusion: We showed significant changes in most hospital indicators after the Covid-19 pandemic, reflecting the effect of this pandemic on the performance of hospitals. Understanding the impact of a pandemic on hospital indicators is necessary for decision-makers to effectively plan an effective pandemic response and to inform resource allocation decisions.