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In the eye of the storm. Long-term impact of the Covid-19 pandemic on healthcare utilization in Lombardy

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Listed:
  • Franzoni, Federico
  • Lucifora, Claudio
  • Russo, Antonio Giampiero
  • Vigani, Daria

Abstract

Covid-19 induced an increase in unmet health needs due to mobility restrictions and social distancing policies, fear of contagion and overload of healthcare facilities. Using administrative data for the Metropolitan Area of Milan in Lombardy and a rigorous empirical strategy, this paper investigates the impact of Covid-19 on the provision of outpatient care between January 2018 and June 2021. We find a large and persistent drop in outpatient treatments, with heterogeneous variations across age groups and chronic status of patients, as well as diagnostic categories of treatments. Results also reveal a significant role played by policy response to Covid-19 and behavioral changes in health-seeking behaviors in shaping the Covid-induced variation in outpatients. Finally, we estimate a cumulative and persistent loss in outpatient care around 25 percent over the period of interest, with an accumulated delay of 4.5 standard months.

Suggested Citation

  • Franzoni, Federico & Lucifora, Claudio & Russo, Antonio Giampiero & Vigani, Daria, 2025. "In the eye of the storm. Long-term impact of the Covid-19 pandemic on healthcare utilization in Lombardy," Economics & Human Biology, Elsevier, vol. 58(C).
    • Handle: RePEc:eee:ehbiol:v:58:y:2025:i:c:s1570677x25000309
    DOI: 10.1016/j.ehb.2025.101497
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    1. Koji Makiyama & Takayuki Kawashima & Shuhei Nomura & Akifumi Eguchi & Daisuke Yoneoka & Yuta Tanoue & Yumi Kawamura & Haruka Sakamoto & Stuart Gilmour & Shoi Shi & Kentaro Matsuura & Shinya Uryu & Mas, 2021. "Trends in Healthcare Access in Japan during the First Wave of the COVID-19 Pandemic, up to June 2020," IJERPH, MDPI, vol. 18(6), pages 1-11, March.
    2. Minjung Lee & Myoungsoon You, 2021. "Avoidance of Healthcare Utilization in South Korea during the Coronavirus Disease 2019 (COVID-19) Pandemic," IJERPH, MDPI, vol. 18(8), pages 1-14, April.
    3. Giovanni Immordino & Tullio Jappelli & Tommaso Oliviero & Alberto Zazzaro, 2022. "Fear of COVID‐19 contagion and consumption: Evidence from a survey of Italian households," Health Economics, John Wiley & Sons, Ltd., vol. 31(3), pages 496-507, March.
    4. Victoria Baranov & Pauline Grosjean & Fatima Jamal Khan & Sarah Walker, 2022. "The impact of COVID‐related economic shocks on household mental health in Pakistan," Health Economics, John Wiley & Sons, Ltd., vol. 31(10), pages 2208-2228, October.
    5. Cantor, Jonathan & Sood, Neeraj & Bravata, Dena M. & Pera, Megan & Whaley, Christopher, 2022. "The impact of the COVID-19 pandemic and policy response on health care utilization: Evidence from county-level medical claims and cellphone data," Journal of Health Economics, Elsevier, vol. 82(C).
    6. Feng Huang & Hong Liu, 2023. "The impact of the COVID‐19 pandemic and related policy responses on non‐COVID‐19 healthcare utilization in China," Health Economics, John Wiley & Sons, Ltd., vol. 32(3), pages 620-638, March.
    7. Claudio Lucifora & Antonio Russo & Daria Vigani, 2021. "Does prescribing appropriateness reduce health expenditures? Main effects and unintended outcomes," DISCE - Working Papers del Dipartimento di Economia e Finanza def103, Università Cattolica del Sacro Cuore, Dipartimenti e Istituti di Scienze Economiche (DISCE).
    8. Gualano, Maria Rosaria & Corradi, Alessio & Voglino, Gianluca & Bert, Fabrizio & Siliquini, Roberta, 2021. "Beyond COVID-19: a cross-sectional study in Italy exploring the covid collateral impacts on healthcare services," Health Policy, Elsevier, vol. 125(7), pages 869-876.
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    Keywords

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    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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