Healthcare system resilience during the COVID-19 pandemic in Lithuania: Insights from outpatient healthcare
1
Department of Health management. Faculty of Public health, Lithuanian university of health sciences, Kaunas, Lithuania
Popul. Med. 2026;8(Supplement Supplement 1):A1799
ABSTRACT
BACKGROUND:
The COVID-19 pandemic has highlighted critical challenges faced by healthcare systems worldwide, particularly in the provision and use of outpatient healthcare services. However, empirical information on how different levels of outpatient healthcare services and regional health systems responded to the onset of the pandemic remains limited. The aim of this study is to assess the impact of the COVID-19 pandemic on the use of outpatient healthcare services at different levels, emphasizing healthcare system functioning and resilience in Lithuania.
METHODS:
National data on outpatient healthcare services use in Lithuania during 2017-2023 were analyzed. The dependent variable was the number of outpatient visits per 100 residents. Differences between population groups were assessed using the Mann–Whitney U test. Multiple linear regression analysis was used, including service level, age group, gender and place of residence.
RESULTS:
The onset of the COVID-19 pandemic was significantly associated with a reduction in outpatient healthcare services used across all service levels. The most significant decrease occurred in primary level of outpatient services (B = –307.2; p < 0.001), with a stronger effect observed in urban areas. Although partial recovery in this level services use was noted in later pandemic periods, pre-pandemic levels were not reached. Outpatient services at secondary and tertiary levels also declined, though the effect was weaker and varied by place of residence. Overall service use decreased in both urban and rural areas, with more pronounced but statistically insignificant recovery trends in rural areas. The pandemic effect remained significant after adjusting for demographic and structural factors.
CONCLUSIONS:
The COVID-19 pandemic exposed the vulnerability of the outpatient healthcare system, particularly primary care, and revealed territorial disparities in healthcare system resilience in Lithuania. Strengthening primary outpatient care capacity and enhancing system adaptability are essential to ensure preparedness for future public health crises.
The COVID-19 pandemic has highlighted critical challenges faced by healthcare systems worldwide, particularly in the provision and use of outpatient healthcare services. However, empirical information on how different levels of outpatient healthcare services and regional health systems responded to the onset of the pandemic remains limited. The aim of this study is to assess the impact of the COVID-19 pandemic on the use of outpatient healthcare services at different levels, emphasizing healthcare system functioning and resilience in Lithuania.
METHODS:
National data on outpatient healthcare services use in Lithuania during 2017-2023 were analyzed. The dependent variable was the number of outpatient visits per 100 residents. Differences between population groups were assessed using the Mann–Whitney U test. Multiple linear regression analysis was used, including service level, age group, gender and place of residence.
RESULTS:
The onset of the COVID-19 pandemic was significantly associated with a reduction in outpatient healthcare services used across all service levels. The most significant decrease occurred in primary level of outpatient services (B = –307.2; p < 0.001), with a stronger effect observed in urban areas. Although partial recovery in this level services use was noted in later pandemic periods, pre-pandemic levels were not reached. Outpatient services at secondary and tertiary levels also declined, though the effect was weaker and varied by place of residence. Overall service use decreased in both urban and rural areas, with more pronounced but statistically insignificant recovery trends in rural areas. The pandemic effect remained significant after adjusting for demographic and structural factors.
CONCLUSIONS:
The COVID-19 pandemic exposed the vulnerability of the outpatient healthcare system, particularly primary care, and revealed territorial disparities in healthcare system resilience in Lithuania. Strengthening primary outpatient care capacity and enhancing system adaptability are essential to ensure preparedness for future public health crises.
| eISSN: | 2654-1459 |
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