Determinants of Healthcare Utilisation Among Post-COVID Syndrome Patients: A Population-Based Study in Malaysia

Determinants of Healthcare Utilisation Among Post-COVID Syndrome Patients: A Population-Based Study in Malaysia | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Determinants of Healthcare Utilisation Among Post-COVID Syndrome Patients: A Population-Based Study in Malaysia Nur Insyirah Sha’ari, Aniza Ismail, Ruhana Sk Abd Razak, Aznida Firzah Abdul Aziz, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6935323/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 30 Mar, 2026 Read the published version in Scientific Reports → Version 1 posted 11 You are reading this latest preprint version Abstract 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. Eligible participants were adults (≥ 18 years old) who had been followed up due to ongoing COVID-19 symptoms beyond 12 weeks from the acute illness before data collection began. Universal sampling was applied. The proportion of the reported data on socio-demographics, health status, PCS symptoms, health-related quality of life (HRQoL) (EQ-5D-5L), and mental health status (DASS-21) was 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) EQ-5D-5L 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 multivariable model indicated statistically significant effects 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 increased 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. Health sciences/Diseases Health sciences/Health care Health sciences/Risk factors Health sciences/Signs and symptoms Chronic post-COVID syndrome factors healthcare utilisation cross-sectional Malaysian Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 30 Mar, 2026 Read the published version in Scientific Reports → Version 1 posted Editorial decision: Revision requested 18 Dec, 2025 Reviews received at journal 01 Oct, 2025 Reviewers agreed at journal 19 Sep, 2025 Reviews received at journal 31 Jul, 2025 Reviewers agreed at journal 30 Jul, 2025 Reviewers agreed at journal 27 Jul, 2025 Reviewers invited by journal 25 Jul, 2025 Editor assigned by journal 25 Jul, 2025 Editor invited by journal 27 Jun, 2025 Submission checks completed at journal 27 Jun, 2025 First submitted to journal 20 Jun, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6935323","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":491605837,"identity":"bbf9f692-45bb-442e-80bf-a5ce89c08de7","order_by":0,"name":"Nur Insyirah Sha’ari","email":"","orcid":"","institution":"Universiti Kebangsaan Malaysia","correspondingAuthor":false,"prefix":"","firstName":"Nur","middleName":"Insyirah","lastName":"Sha’ari","suffix":""},{"id":491605839,"identity":"b92731a7-d8aa-4bd2-8b9e-7cdf7d179f07","order_by":1,"name":"Aniza 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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. Eligible participants were adults (\u0026ge;\u0026thinsp;18 years old) who had been followed up due to ongoing COVID-19 symptoms beyond 12 weeks from the acute illness before data collection began. Universal sampling was applied. The proportion of the reported data on socio-demographics, health status, PCS symptoms, health-related quality of life (HRQoL) (EQ-5D-5L), and mental health status (DASS-21) was 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\u0026rsquo; mean (SD) EQ-5D-5L 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 multivariable model indicated statistically significant effects of the current vaccine doses (β\u0026thinsp;=\u0026thinsp;0.121; p\u0026thinsp;=\u0026thinsp;0.049), history of hospitalisation (β\u0026thinsp;=\u0026thinsp;0.156; p\u0026thinsp;=\u0026thinsp;0.012), history of intensive care unit (ICU) admission (β\u0026thinsp;=\u0026thinsp;0.275; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), chest pain (β\u0026thinsp;=\u0026thinsp;0.137; p\u0026thinsp;=\u0026thinsp;0.029), and EQ-VAS score (β = -0.257; p\u0026thinsp;=\u0026thinsp;0.012) on increased healthcare utilisation. 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