The effect of epidemic outbreak on healthcare usage: Lessons from the 2015 Middle East respiratory syndrome outbreak in South Korea

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.