Introduction The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimate the number of visits lost through December 2020. Methods We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico’s population—65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale. Results The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change. Conclusion Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico. Data are available in a public, open access repository.

中文翻译：

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COVID-19 期间墨西哥基本卫生服务中断：卫生信息系统数据的中断时间序列分析

简介 COVID-19 大流行扰乱了世界各地的卫生系统。本研究的目的是估计大流行对墨西哥基本卫生服务使用和结果的总体影响，描述 24 个月内观察到的和预测的服务趋势，并估计到 2020 年 12 月损失的就诊人数。我们使用的方法墨西哥社会保障研究所 (IMSS) 2019 年 1 月至 2020 年 12 月的健康信息系统数据，该研究所为墨西哥一半以上人口（6500 万人）提供医疗服务。我们的分析包括九项服务使用指标以及生殖、妇幼健康和非传染性疾病服务的三项结果指标。我们使用间断时间序列设计和线性广义估计方程模型来估计 2020 年 4 月至 12 月的服务使用和结果的变化。使用风险比率规模的平均边际效应来表达估计值。结果 研究发现，在墨西哥的九个卫生服务机构中，估计有 874 万名患者流失。其中包括乳腺癌和宫颈癌筛查下降超过三分之二（分别为 79% 和 68%），患病儿童就诊和女性避孕服务下降超过一半，儿童疫苗接种、糖尿病、高血压和产前保健咨询下降约三分之一，IMSS 的交付量下降了 10%。在患者预后方面，病情得到控制的糖尿病和高血压患者比例分别下降了22%和17%。剖腹产率没有变化。结论 卫生服务的严重中断表明，大流行已经使墨西哥卫生系统的恢复能力变得紧张，需要紧急努力恢复基本服务，并计划弥补错过的预防性护理，即使墨西哥的 COVID-19 危机仍在继续。数据可在公共、开放访问存储库中获取。