Impact of COVID-19 on hospital visit behaviour in cancer patients in Japan: a nationwide study

Objectives: Lockdowns and outing restrictions during the COVID-19 pandemic may have altered attitudes towards hospital visits. This study aimed to investigate changes in long-distance visits outside of secondary healthcare service areas (SHSA) among cancer patients in Japan.

Design: Retrospective observational study.

Setting: Inpatient data from the Japanese Diagnosis Procedure Combination database.

Primary and secondary outcome measures: We retrospectively analysed inpatient data from January 2018 to December 2021, extracted from the Japanese Diagnosis Procedure Combination database. The study examined whether the patient's hospital was within their residence's SHSA and compared the admission rates before and after the pandemic.

Results: The data of a total of 2 394 760 patients were analysed. Admission rates outside the SHSA significantly decreased after the pandemic compared with prepandemic years (26.67% and 27.58%, respectively, p<0.001). Significant reductions were observed in nearly all age groups over 30 years old, but not in younger ones. Characteristics of patients' residences, including COVID-19 infection rates, population density and the number of regional cancer hospitals, were also influential factors. The cancer site was a significant factor, with the respiratory system showing a 3.77% decrease, particularly a 5.29% decrease in those who needed surgeries that are not highly specialised (p<0.001).

Conclusions: Admission to distant hospitals among cancer patients decreased following the COVID-19 pandemic, indicating a restraint in their behaviour of visiting distant hospitals. The appropriate allocation of specialised hospitals will serve as a measure for the next pandemic.