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Objectives: Whether and how the COVID-19 pandemic affected utilization of routine medical care in areas with low infection risk, such as Taiwan, has not been widely addressed. We aimed to evaluate the impact of the COVID-19 pandemic on access to medical care., Study Design: Before and after exposure (COVID-19 pandemic) design with a historical control group for comparison of clinical visits based on a retrospective cohort of 6722 customary patients of a community hospital in Zhunan, Taiwan., Methods: Repeated measurements of medical utilization in 4-month periods (January to April) of 2019 and 2020 in light of the emerging COVID-19 pandemic were collected. Access to medical care was defined as the mean frequencies of clinical visits. The impacts of the COVID-19 pandemic on access in the overall and specific groups were quantified with a multivariable Poisson regression model., Results: The overall outpatient visits per month declined by 39% (rate ratio [RR], 0.61; P < .0001) after adjusting for demographics. A notable reduction in visits was observed in foreign patients (RR, 0.50; P < .0001). The visits of the elderly (≥ 80 years) were the most frequent before the COVID-19 pandemic but were reduced by 44% (RR, 0.56; P < .0001) after it began. Most disease categories revealed a declining trend, but the size of reduction varied by International Classification of Diseases codes., Conclusions: The COVID-19 pandemic prevented some individuals from keeping regular medical appointments even in an area with a low infection risk. Our findings imply that more research is required to mitigate the effects of delayed medical care for patients who infrequently utilized medical care during and after the long-lasting pandemic period.

Background: Prior to the introduction of universal hepatitis B virus (HBV) vaccination in Taiwan in 1984, 15-20% of the general population were chronic HBV carriers., Methods: We forecasted and quantified the declining HBV carrier rate 20 years subsequent to the implementation of universal HBV vaccination in Taiwan. At a Taiwanese university, 28,763 freshmen tested for serum HBsAg level were divided into ten age cohorts by date of birth, from July 1976 to June 1986 inclusive. Comparisons of HBsAg carrier rates according to gender were examined with the Z test. Regression methods and a time series model were applied to our sample to forecast trends in changes to the HBsAg carrier rate for the next five years., Results: Regression analysis demonstrated a trend toward declining HBsAg-positive carrier rates. The HBsAg carrier rate for male students decreased from 16.8% (for those born between July 1976 and June 1977) to 2.2% (for those born between July 1985 and June 1986). The carrier rate for their female counterparts over the same period declined from 12.2% to 2.4%. The HBsAg carrier rate for male participants was significantly greater than that of their female counterparts for certain years during the test period. The results of time series analysis suggests the HBsAg carrier status rate will approach zero for students born after July 1987 (expected to enrol in the university in 2006)., Conclusions: Our data demonstrate that in order for the HBV carrier rate to approximate zero, universal vaccination programs need to continue for at least 21 years.