Changes in the utilisation of acute hospital care in Ireland during the first wave of COVID-19
Background Reduced and delayed presentations for non-COVID-19 illness during the COVID-19 pandemic have implications for population health and health systems. The aim of this study was to quantify and characterise changes in acute hospital healthcare utilisation during the first wave of COVID-19 in...
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| Veröffentlicht in: | European journal of public health 2021-10, Vol.31 (Supplement_3) |
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| creator | Marron, L Burke, S Kavanagh, P |
| description | Background
Reduced and delayed presentations for non-COVID-19 illness during the COVID-19 pandemic have implications for population health and health systems. The aim of this study was to quantify and characterise changes in acute hospital healthcare utilisation during the first wave of COVID-19 in Ireland to inform healthcare service planning and public health policy.
Methods
A retrospective, population-based, interrupted time-trend study was conducted, using two national datasets, from 6th January to 5th July 2020.
Results
Comparison between time periods pre- and post-onset of the COVID-19 pandemic within 2020 showed that there were 81,712 fewer Emergency Department (ED) presentations (-18.8%), 19,692 fewer admissions from ED (-17.4%) and 210,357 fewer non-COVID-19 hospital admissions (-35.0%). Reductions were greatest at the peak of population restrictions, at extremes of age and for elective admissions. In the period immediately following the first wave, healthcare utilisation remained below pre-COVID-19 levels however, there were increases in emergency alcohol-related admissions (Rate Ratio 1.22, 95% CI 1.03, 1.43, p-value 0.016), admissions with self-harm (Rate Ratio 1.39, 95% CI 1.01, 1.91, p-value 0.043) and mental health admissions (Rate Ratio 1.28, 95% CI 1.03, 1.60, p-value 0.028).
Conclusions
Public health implications of delayed and lost care will become fully apparent over time. In the short-term, backlogs in care need to managed and population health impacts of COVID-19 and associated restrictions, particularly in relation to mental health and alcohol, need to be addressed through strong public health and health system responses, including the adoption of a pandemic recovery plan. In the long-term, COVID-19 has highlighted weaknesses in the health system and is an opportunity to progress reform towards a universal, high-quality, sustainable and resilient health system, capable of meeting population health needs and responding to future pandemics.
Key messages
The COVID-19 pandemic impacted non-COVID-19 healthcare utilisation in Ireland with evidence of delayed and lost acute hospital care and increased need for emergency mental health and alcohol services.
Population health and health system recovery from COVID-19 is a public health priority. |
| doi_str_mv | 10.1093/eurpub/ckab164.133 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_TOX</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8574686</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/eurpub/ckab164.133</oup_id><sourcerecordid>2597249727</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2573-9cde9549a89d674d5f897c2f8cdc6cdb4b3c8e4b1a9419a6f9de65732815f68e3</originalsourceid><addsrcrecordid>eNqNkV9LwzAUxYsoOKdfwKeAz92aNE2TF0Hqv8FgLyo-GdIkXTO7pibtxG9vZofgmw-XeyHnd264J4ouYTKDCUvnenDdUM7luyghwTOYpkfRBGKC45Qkr8dhhgmMISLoNDrzfpMkSZZTNIneilq0a-2BaUFfazD0pjFe9Ma2wFZAyKHXoLa-M71ogBRO75ULpxvRKqAGZ9r1D1gZ53vwKXZ6zxWrl8VtDNl5dFKJxuuLQ59Gz_d3T8VjvFw9LIqbZSxRlqcxk0qzDDNBmSI5VllFWS5RRaWSRKoSl6mkGpdQMAyZIBVTmgQQUZhVhOp0Gl2PvuEKW62kbnsnGt45sxXui1th-N-X1tR8bXecZjkmlASDq4OBsx-D9j3f2MG14c8cZSxHOFQeVGhUSWe9d7r63QATvg-Cj0HwQxA8BBGgeITs0P1H_w27fY8d</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2597249727</pqid></control><display><type>article</type><title>Changes in the utilisation of acute hospital care in Ireland during the first wave of COVID-19</title><source>Oxford Journals Open Access Collection</source><creator>Marron, L ; Burke, S ; Kavanagh, P</creator><creatorcontrib>Marron, L ; Burke, S ; Kavanagh, P</creatorcontrib><description>Background
Reduced and delayed presentations for non-COVID-19 illness during the COVID-19 pandemic have implications for population health and health systems. The aim of this study was to quantify and characterise changes in acute hospital healthcare utilisation during the first wave of COVID-19 in Ireland to inform healthcare service planning and public health policy.
Methods
A retrospective, population-based, interrupted time-trend study was conducted, using two national datasets, from 6th January to 5th July 2020.
Results
Comparison between time periods pre- and post-onset of the COVID-19 pandemic within 2020 showed that there were 81,712 fewer Emergency Department (ED) presentations (-18.8%), 19,692 fewer admissions from ED (-17.4%) and 210,357 fewer non-COVID-19 hospital admissions (-35.0%). Reductions were greatest at the peak of population restrictions, at extremes of age and for elective admissions. In the period immediately following the first wave, healthcare utilisation remained below pre-COVID-19 levels however, there were increases in emergency alcohol-related admissions (Rate Ratio 1.22, 95% CI 1.03, 1.43, p-value 0.016), admissions with self-harm (Rate Ratio 1.39, 95% CI 1.01, 1.91, p-value 0.043) and mental health admissions (Rate Ratio 1.28, 95% CI 1.03, 1.60, p-value 0.028).
Conclusions
Public health implications of delayed and lost care will become fully apparent over time. In the short-term, backlogs in care need to managed and population health impacts of COVID-19 and associated restrictions, particularly in relation to mental health and alcohol, need to be addressed through strong public health and health system responses, including the adoption of a pandemic recovery plan. In the long-term, COVID-19 has highlighted weaknesses in the health system and is an opportunity to progress reform towards a universal, high-quality, sustainable and resilient health system, capable of meeting population health needs and responding to future pandemics.
Key messages
The COVID-19 pandemic impacted non-COVID-19 healthcare utilisation in Ireland with evidence of delayed and lost acute hospital care and increased need for emergency mental health and alcohol services.
Population health and health system recovery from COVID-19 is a public health priority.</description><identifier>ISSN: 1101-1262</identifier><identifier>EISSN: 1464-360X</identifier><identifier>DOI: 10.1093/eurpub/ckab164.133</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Alcohol ; Coronaviruses ; COVID-19 ; Emergency medical care ; Emergency medical services ; Emergency services ; Health care ; Health care policy ; Health needs ; Health planning ; Health policy ; Health services ; Health services utilization ; Hospitalization ; Mental health ; Mental health services ; Pandemics ; Parallel Programme ; Population ; Population policy ; Population studies ; Public health ; Recovery ; Rehabilitation ; Self destructive behavior ; Self-injury ; Time periods ; Value</subject><ispartof>European journal of public health, 2021-10, Vol.31 (Supplement_3)</ispartof><rights>The Author(s) 2021. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved. 2021</rights><rights>The Author(s) 2021. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2573-9cde9549a89d674d5f897c2f8cdc6cdb4b3c8e4b1a9419a6f9de65732815f68e3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8574686/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8574686/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,1598,27845,27903,27904,33753,53770,53772</link.rule.ids><linktorsrc>$$Uhttps://dx.doi.org/10.1093/eurpub/ckab164.133$$EView_record_in_Oxford_University_Press$$FView_record_in_$$GOxford_University_Press</linktorsrc></links><search><creatorcontrib>Marron, L</creatorcontrib><creatorcontrib>Burke, S</creatorcontrib><creatorcontrib>Kavanagh, P</creatorcontrib><title>Changes in the utilisation of acute hospital care in Ireland during the first wave of COVID-19</title><title>European journal of public health</title><description>Background
Reduced and delayed presentations for non-COVID-19 illness during the COVID-19 pandemic have implications for population health and health systems. The aim of this study was to quantify and characterise changes in acute hospital healthcare utilisation during the first wave of COVID-19 in Ireland to inform healthcare service planning and public health policy.
Methods
A retrospective, population-based, interrupted time-trend study was conducted, using two national datasets, from 6th January to 5th July 2020.
Results
Comparison between time periods pre- and post-onset of the COVID-19 pandemic within 2020 showed that there were 81,712 fewer Emergency Department (ED) presentations (-18.8%), 19,692 fewer admissions from ED (-17.4%) and 210,357 fewer non-COVID-19 hospital admissions (-35.0%). Reductions were greatest at the peak of population restrictions, at extremes of age and for elective admissions. In the period immediately following the first wave, healthcare utilisation remained below pre-COVID-19 levels however, there were increases in emergency alcohol-related admissions (Rate Ratio 1.22, 95% CI 1.03, 1.43, p-value 0.016), admissions with self-harm (Rate Ratio 1.39, 95% CI 1.01, 1.91, p-value 0.043) and mental health admissions (Rate Ratio 1.28, 95% CI 1.03, 1.60, p-value 0.028).
Conclusions
Public health implications of delayed and lost care will become fully apparent over time. In the short-term, backlogs in care need to managed and population health impacts of COVID-19 and associated restrictions, particularly in relation to mental health and alcohol, need to be addressed through strong public health and health system responses, including the adoption of a pandemic recovery plan. In the long-term, COVID-19 has highlighted weaknesses in the health system and is an opportunity to progress reform towards a universal, high-quality, sustainable and resilient health system, capable of meeting population health needs and responding to future pandemics.
Key messages
The COVID-19 pandemic impacted non-COVID-19 healthcare utilisation in Ireland with evidence of delayed and lost acute hospital care and increased need for emergency mental health and alcohol services.
Population health and health system recovery from COVID-19 is a public health priority.</description><subject>Alcohol</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>Emergency medical care</subject><subject>Emergency medical services</subject><subject>Emergency services</subject><subject>Health care</subject><subject>Health care policy</subject><subject>Health needs</subject><subject>Health planning</subject><subject>Health policy</subject><subject>Health services</subject><subject>Health services utilization</subject><subject>Hospitalization</subject><subject>Mental health</subject><subject>Mental health services</subject><subject>Pandemics</subject><subject>Parallel Programme</subject><subject>Population</subject><subject>Population policy</subject><subject>Population studies</subject><subject>Public health</subject><subject>Recovery</subject><subject>Rehabilitation</subject><subject>Self destructive behavior</subject><subject>Self-injury</subject><subject>Time periods</subject><subject>Value</subject><issn>1101-1262</issn><issn>1464-360X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>7TQ</sourceid><sourceid>BHHNA</sourceid><recordid>eNqNkV9LwzAUxYsoOKdfwKeAz92aNE2TF0Hqv8FgLyo-GdIkXTO7pibtxG9vZofgmw-XeyHnd264J4ouYTKDCUvnenDdUM7luyghwTOYpkfRBGKC45Qkr8dhhgmMISLoNDrzfpMkSZZTNIneilq0a-2BaUFfazD0pjFe9Ma2wFZAyKHXoLa-M71ogBRO75ULpxvRKqAGZ9r1D1gZ53vwKXZ6zxWrl8VtDNl5dFKJxuuLQ59Gz_d3T8VjvFw9LIqbZSxRlqcxk0qzDDNBmSI5VllFWS5RRaWSRKoSl6mkGpdQMAyZIBVTmgQQUZhVhOp0Gl2PvuEKW62kbnsnGt45sxXui1th-N-X1tR8bXecZjkmlASDq4OBsx-D9j3f2MG14c8cZSxHOFQeVGhUSWe9d7r63QATvg-Cj0HwQxA8BBGgeITs0P1H_w27fY8d</recordid><startdate>20211020</startdate><enddate>20211020</enddate><creator>Marron, L</creator><creator>Burke, S</creator><creator>Kavanagh, P</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7T2</scope><scope>7TQ</scope><scope>7U3</scope><scope>BHHNA</scope><scope>C1K</scope><scope>DHY</scope><scope>DON</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>5PM</scope></search><sort><creationdate>20211020</creationdate><title>Changes in the utilisation of acute hospital care in Ireland during the first wave of COVID-19</title><author>Marron, L ; Burke, S ; Kavanagh, P</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2573-9cde9549a89d674d5f897c2f8cdc6cdb4b3c8e4b1a9419a6f9de65732815f68e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Alcohol</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>Emergency medical care</topic><topic>Emergency medical services</topic><topic>Emergency services</topic><topic>Health care</topic><topic>Health care policy</topic><topic>Health needs</topic><topic>Health planning</topic><topic>Health policy</topic><topic>Health services</topic><topic>Health services utilization</topic><topic>Hospitalization</topic><topic>Mental health</topic><topic>Mental health services</topic><topic>Pandemics</topic><topic>Parallel Programme</topic><topic>Population</topic><topic>Population policy</topic><topic>Population studies</topic><topic>Public health</topic><topic>Recovery</topic><topic>Rehabilitation</topic><topic>Self destructive behavior</topic><topic>Self-injury</topic><topic>Time periods</topic><topic>Value</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Marron, L</creatorcontrib><creatorcontrib>Burke, S</creatorcontrib><creatorcontrib>Kavanagh, P</creatorcontrib><collection>CrossRef</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>PAIS Index</collection><collection>Social Services Abstracts</collection><collection>Sociological Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>PAIS International</collection><collection>PAIS International (Ovid)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European journal of public health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>Marron, L</au><au>Burke, S</au><au>Kavanagh, P</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Changes in the utilisation of acute hospital care in Ireland during the first wave of COVID-19</atitle><jtitle>European journal of public health</jtitle><date>2021-10-20</date><risdate>2021</risdate><volume>31</volume><issue>Supplement_3</issue><issn>1101-1262</issn><eissn>1464-360X</eissn><abstract>Background
Reduced and delayed presentations for non-COVID-19 illness during the COVID-19 pandemic have implications for population health and health systems. The aim of this study was to quantify and characterise changes in acute hospital healthcare utilisation during the first wave of COVID-19 in Ireland to inform healthcare service planning and public health policy.
Methods
A retrospective, population-based, interrupted time-trend study was conducted, using two national datasets, from 6th January to 5th July 2020.
Results
Comparison between time periods pre- and post-onset of the COVID-19 pandemic within 2020 showed that there were 81,712 fewer Emergency Department (ED) presentations (-18.8%), 19,692 fewer admissions from ED (-17.4%) and 210,357 fewer non-COVID-19 hospital admissions (-35.0%). Reductions were greatest at the peak of population restrictions, at extremes of age and for elective admissions. In the period immediately following the first wave, healthcare utilisation remained below pre-COVID-19 levels however, there were increases in emergency alcohol-related admissions (Rate Ratio 1.22, 95% CI 1.03, 1.43, p-value 0.016), admissions with self-harm (Rate Ratio 1.39, 95% CI 1.01, 1.91, p-value 0.043) and mental health admissions (Rate Ratio 1.28, 95% CI 1.03, 1.60, p-value 0.028).
Conclusions
Public health implications of delayed and lost care will become fully apparent over time. In the short-term, backlogs in care need to managed and population health impacts of COVID-19 and associated restrictions, particularly in relation to mental health and alcohol, need to be addressed through strong public health and health system responses, including the adoption of a pandemic recovery plan. In the long-term, COVID-19 has highlighted weaknesses in the health system and is an opportunity to progress reform towards a universal, high-quality, sustainable and resilient health system, capable of meeting population health needs and responding to future pandemics.
Key messages
The COVID-19 pandemic impacted non-COVID-19 healthcare utilisation in Ireland with evidence of delayed and lost acute hospital care and increased need for emergency mental health and alcohol services.
Population health and health system recovery from COVID-19 is a public health priority.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><doi>10.1093/eurpub/ckab164.133</doi><oa>free_for_read</oa></addata></record> |
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| ispartof | European journal of public health, 2021-10, Vol.31 (Supplement_3) |
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| source | Oxford Journals Open Access Collection |
| subjects | Alcohol Coronaviruses COVID-19 Emergency medical care Emergency medical services Emergency services Health care Health care policy Health needs Health planning Health policy Health services Health services utilization Hospitalization Mental health Mental health services Pandemics Parallel Programme Population Population policy Population studies Public health Recovery Rehabilitation Self destructive behavior Self-injury Time periods Value |
| title | Changes in the utilisation of acute hospital care in Ireland during the first wave of COVID-19 |
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