¹Ulsan University Hospital, Department of Psychiatry, Ulsan, Korea, Republic of

Background: The COVID-19 pandemic and related shutdown measures substantially disrupted healthcare utilization. For patients with schizophrenia and bipolar disorder, continuous outpatient care is critical to maintain medication adherence and prevent relapse. Disruptions in outpatient visits during the COVID-19 period may increase the risk of medication nonadherence.

Aims & Objectives: This study aimed to identify factors associated with continuity of outpatient care during the COVID-19 period and to characterize medication nonadherence related to discontinuation of outpatient treatment.

Method: This population-based study utilized data from the Korean National Health Insurance Service. Patients with schizophrenia or bipolar disorder who had regular outpatient visits during the pre–COVID-19 period (2017–2018) were included. Outpatient visit continuity after the onset of COVID-19 (2019 onward) was examined, and patients were categorized into continuation and discontinuation groups. Demographic and socioeconomic variables, including sex, age, region of residence, and health insurance premium level, were compared.

Results: Among patients with schizophrenia, outpatient visit continuity differed significantly according to sex(P<0.001), age(p<0.001), urban residence(P<0.001), and health insurance premium level(P<0.001). In contrast, among patients with bipolar disorder, differences were observed only according to age(P<0.001).

Discussion & Conclusions: These findings suggest that tailored interventions based on demographic and socioeconomic characteristics may be necessary to improve medication adherence among patients with schizophrenia during public health crises such as the COVID-19 pandemic.