TY  - JOUR
T1  - Has the COVID-19 pandemic changed existing patterns of non-COVID-19 health care utilization? A retrospective analysis of six regions in Europe
AU  - Aldridge, Sarah J.
AU  - Schmidt, Andrea E.
AU  - Thißen, Martin
AU  - Bernal-Delgado, Enrique
AU  - Estupiñán-Romero, Francisco
AU  - González-Galindo, Javier
AU  - Dolanski-Aghamanoukjan, Lorenz
AU  - Mathis-Edenhofer, Stefan
AU  - Buble, Tamara
AU  - Križ, Klea
AU  - Vuković, Jakov
AU  - Palmieri, Luigi
AU  - Unim, Brigid
AU  - Meulman, Iris
AU  - Owen, Rhiannon K.
AU  - Lyons, Ronan A.
AB  - Background:

Resilience of national health systems in Europe remains a major concern in times of multiple crises and as more evidence is emerging relating to the indirect effects of the COVID-19 pandemic on health care utilization (HCU), resulting from de-prioritization of regular, non-pandemic healthcare services. Most extant studies focus on regional, disease specific or early pandemic HCU creating difficulties in comparing across multiple countries. We provide a comparatively broad definition of HCU across multiple countries, with potential to expand across regions and timeframes.
Methods:

Using a cross-country federated research infrastructure (FRI), we examined HCU for acute cardiovascular events, elective surgeries and serious trauma. Aggregated data were used in forecast modelling to identify changes from predicted European age-standardized counts via fitted regressions (2017–19), compared against post-pandemic data.
Results:

We found that elective surgeries were most affected, universally falling below predicted levels in 2020. For cardiovascular HCU, we found lower-than-expected cases in every region for heart attacks and displayed large sex differences. Serious trauma was the least impacted by the COVID-19 pandemic.
Conclusion:

The strength of this study comes from the use of the European Population Health Information Research Infrastructure’s (PHIRI) FRI, allowing for rapid analysis of regional differences to assess indirect impacts of events such as pandemics. There are marked differences in the capacity of services to return to normal in terms of elective surgery; additionally, we found considerable differences between men and women which requires further research on potential sex or gender patterns of HCU during crises.
KW  - Adult
KW  - Aged
KW  - COVID-19* / epidemiology
KW  - Cardiovascular Diseases / epidemiology
KW  - Elective Surgical Procedures* / statistics & numerical data
KW  - Europe / epidemiology
KW  - Female
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Pandemics
KW  - Patient Acceptance of Health Care* / statistics & numerical data
KW  - Retrospective Studies
KW  - SARS-CoV-2
KW  - Wounds and Injuries / epidemiology
KW  - 610 Medizin und Gesundheit
PY  - 2024
LA  - eng
PB  - Robert Koch-Institut
JO  - European Journal of Public Health
SP  - i67
EP  - i73
DO  - 10.1093/eurpub/ckad180
ER  -