Determinants of healthcare utilisation among post-COVID syndrome patients: a population-based study in Malaysia

Post-COVID syndrome (PCS) occurs three months after the initial onset of COVID-19 without an alternative diagnosis. The exponential PCS case growth has significantly influenced healthcare utilisation. This study aimed to determine the factors associated with healthcare utilisation among post-COVID syndrome (PCS) patients in Selangor, Malaysia. A cross-sectional study was conducted from August 2023 and November 2023 at the Hospital Sungai Buloh COVID-19 Rehabilitation Outpatient Specialised Services (CROSS) Centre. Adults aged ≥ 18 years with ongoing COVID-19–related symptoms persisting for more than 12 weeks after acute illness were included using universal sampling. Proportional distributions of sociodemographic factors, health status, post-COVID-19 syndrome symptoms, health-related quality of life (EQ-5D-5L), and mental health outcomes (DASS-21) were assessed. The factors associated with healthcare utilisation were evaluated using a multiple regression model. Of 220 patients, 58.6% were male. The mean ± standard deviation (SD) patient age was 53.04 ± 12.87 years, and 64.5% of the patients were Malay. Overall, the patients’ mean ± SD of EQ-5D-5 L index, and EQ-VAS scores were 0.90 ± 0.143 and 78.25 ± 9.905, respectively. The depression, anxiety, and stress mean scores were categorised as normal. The mean ± SD number of outpatient clinic visits was 3.26 ± 1.24. The multiple regression model indicated statistically significant associations of the current vaccine doses (β = 0.121; p = 0.049), history of hospitalisation (β = 0.156; p = 0.012), history of intensive care unit (ICU) admission (β = 0.275; p < 0.001), chest pain (β = 0.137; p = 0.029), and EQ-VAS score (β = -0.257; p = 0.012) on higher healthcare utilisation. These results could be used as a model for implementing future healthcare management and programs related to PCS to provide Malaysian patients with proper support.