Authors:

Abstract

Background: COVID-19 adversely affected economic activities and resulted in changes in healthcare seeking behaviour among people.

Objective: To assess the healthcare access, patient experiences and economic impacts due to COVID-19 pandemic in Sri Lanka

Methods: An online survey was conducted in June-July 2021 involving 449 adults in the Western Province, Sri Lanka. Data on participants' sociodemographic and economic status, comorbidities, access, and healthcare-seeking behaviours were collected using a questionnaire.

Results: 449 respondents completed the survey. 55%(n=173) and 74% (n=97) had experienced a negative impact on their main and additional income, respectively. Fifteen per cent (n=66) reported cutting down on meals or the amount consumed, and 30%(n=135) reported that they had to cut down on the amount of food bought.

Fifteen per cent reported influenza-like illness during the pandemic, of which 34% did not seek healthcare. Of the participants who sought healthcare, 42%(n=19) went to a private hospital, and 22%(n=10) to a general practitioner. Twenty per cent (n=115) had a chronic illness, and 72%(n=83) were on regular medication. The majority (65%;n=70) bought drugs from private pharmacies, and 58%(n=62) got investigations done at private laboratories. Forty-eight per cent agreed that the pandemic led to delays in healthcare seeking, as they were unaware of the services rendered. Of the participants, 9% (n=39) and 3.2%(n=14) had incurred catastrophic healthcare expenses at 10% and 25% of their total income.

Conclusion: Residents of the Western province were severely economically affected by the pandemic. Healthcare access and utilization patterns changed among patients with influenza-like illness and chronic-illnesses during the pandemic. Participants had incurred high out-of-pocket expenditures.

Keywords: Healthcare access, Patient reported experiences, Economic impacts COVID-19 pandemic