Impact of the COVID-19 pandemic on primary care for individuals with autism spectrum disorder in the Peruvian health system: A time series analysis

Purpose: The COVID-19 pandemic disrupted health service delivery in low- and middle-income countries such as Peru, potentially affecting primary care utilization among individuals with autism spectrum disorder (ASD). We assessed the impact of the pandemic on primary care utilization for individuals with ASD within two Peruvian health insurance systems.Methods: We conducted a cross-sectional study using an interrupted time-series design with administrative data from the Comprehensive Health Insurance (Seguro Integral de Salud, SIS) and Health Service Providers (Entidades Prestadoras de Salud, EPS) from January 2016 to February 2024.Results: We included 211,879 SIS-financed users and 3,391 EPS-financed users. In SIS, the pre-pandemic trend increased by 26.7 unique users per month (p Conclusions: The COVID-19 pandemic was associated with a sharp reduction in recorded primary care utilization for individuals with ASD in Peru, with a larger immediate impact in SIS. Subsequent recovery surpassed pre-pandemic levels, suggesting compensation for accumulated demand and vulnerability to system disruptions.