When an epidemic outbreak occurs, the demand for healthcare services may increase because more people may seek medical care regardless of their infection status. On the other hand, it may decrease because of the fear of getting infected while seeking treatment. Moreover, the epidemic may have lasting effects on individuals' healthcare service usage after it ends. Armed with a representative and detailed individual level healthcare usage dataset, we examine the dynamic effect of the Middle East respiratory syndrome (MERS) outbreak which occurred in South Korea in 2015. To be more specific, we select patients who lived in regions where the MERS outbreak took place as the treatment group, and patients who lived in regions where MERS-related events never occurred as the control group. Using this sample, we apply a difference-in-difference approach with propensity score matching to investigate the effect of epidemic disease on individuals' healthcare service usage. We find that healthcare visits to treat minor diseases during the MERS outbreak showed a significant decrease of 3.7%. This effect was pronounced in large tertiary hospitals (22.7%) and among minors under age 10 (10.1%). We could not find significant changes in visits to treat serious diseases. However, visits to the emergency department showed a temporary but significant decrease (18.1%). After the end of the epidemic, healthcare visits to treat minor diseases significantly increased by 4.0%. This after-effect was pronounced in secondary hospitals (8.7%) and primary healthcare facilities (3.9%) and among minors under age 10. We discuss the implications of our findings for various stakeholders.

中文翻译：

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流行病爆发对医疗保健使用的影响：2015 年韩国中东呼吸综合征爆发的教训

当流行病爆发时，对医疗服务的需求可能会增加，因为更多的人可能会寻求医疗服务，而不管他们的感染状况如何。另一方面，由于害怕在寻求治疗时被感染，它可能会减少。此外，疫情结束后可能会对个人的医疗服务使用产生持久影响。借助具有代表性和详细的个人医疗保健使用数据集，我们研究了 2015 年在韩国发生的中东呼吸综合征 (MERS) 爆发的动态影响。更具体地说，我们选择了居住在 MERS 发生地区的患者爆发发生为治疗组，居住在从未发生过中东呼吸综合征相关事件的地区的患者为对照组。使用这个样本，我们采用倾向得分匹配的差异化方法来研究流行病对个人医疗保健服务使用的影响。我们发现，在 MERS 爆发期间，治疗小病的医疗保健访问量显着下降了 3.7%。这种影响在大型三级医院 (22.7%) 和 10 岁以下的未成年人 (10.1%) 中很明显。我们在治疗严重疾病的访问中没有发现显着变化。然而，急诊科的就诊次数显示出暂时但显着的下降（18.1%）。疫情结束后，小病就诊人数显着增加4.0%。这种后遗症在二级医院 (8.7%) 和初级医疗保健机构 (3.9%) 以及 10 岁以下的未成年人中尤为明显。