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

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.