Pandemic shocks and unintended healthcare disruptions: chronic patients during COVID-19

This paper investigates the effects of pandemic shocks on outpatient care utilisation among chronic patients aged 50 and older in Italy. We merge administrative data on outpatient services with information on excess deaths to proxy the severity of pandemic shocks during COVID-19. To account for confounding factors and individual-level unobserved heterogeneity, we implement an individual-level fixed-effects estimator. Our results indicate that excess deaths are associated with a decline in the probability of receiving at least one medical treatment per month. A heterogeneity analysis reveals that the reduction is more substantial for patients with comorbidities, who exhibit a larger prevalence-response elasticity, indicating that sicker patients are more sensitive to pandemic severity. These findings suggest that pandemic shocks influence healthcare-seeking behaviour even among patients previously thought to have inelastic demand.