Reduced Rate of Inpatient Hospital Admissions in 18 German University Hospitals During the COVID-19 Lockdown

TY - JOUR

T1 - Reduced Rate of Inpatient Hospital Admissions in 18 German University Hospitals During the COVID-19 Lockdown

AU - Kapsner, Lorenz A.

AU - Kampf, Marvin O.

AU - Seuchter, Susanne A.

AU - Gruendner, Julian

AU - Gulden, Christian

AU - Mate, Sebastian

AU - Mang, Jonathan M.

AU - Schüttler, Christina

AU - Deppenwiese, Noemi

AU - Krause, Linda

AU - Zöller, Daniela

AU - Balig, Julien

AU - Fuchs, Timo

AU - Fischer, Patrick

AU - Haverkamp, Christian

AU - Holderried, Martin

AU - Mayer, Gerhard

AU - Stenzhorn, Holger

AU - Stolnicu, Ana

AU - Storck, Michael

AU - Storf, Holger

AU - Zohner, Jochen

AU - Kohlbacher, Oliver

AU - Strzelczyk, Adam

AU - Schüttler, Jürgen

AU - Acker, Till

AU - Boeker, Martin

AU - Kaisers, Udo X.

AU - Kestler, Hans A.

AU - Prokosch, Hans-Ulrich

PY - 2020

Y1 - 2020

N2 - The COVID-19 pandemic has caused strains on health systems worldwide disrupting routine hospital services for all non-COVID patients. Within this retrospective study, we analyzed inpatient hospital admissions across 18 German university hospitals during the 2020 lockdown period compared to 2018. Patients admitted to hospital between January 1 and May 31, 2020 and the corresponding periods in 2018 and 2019 were included in this study. Data derived from electronic health records were collected and analyzed using the data integration center infrastructure implemented in the university hospitals that are part of the four consortia funded by the German Medical Informatics Initiative. Admissions were grouped and counted by ICD 10 chapters and specific reasons for treatment at each site. Pooled aggregated data were centrally analyzed with descriptive statistics to compare absolute and relative differences between time periods of different years. The results illustrate how care process adoptions depended on the COVID-19 epidemiological situation and the criticality of the disease. Overall inpatient hospital admissions decreased by 35% in weeks 1 to 4 and by 30.3% in weeks 5 to 8 after the lockdown announcement compared to 2018. Even hospital admissions for critical care conditions such as malignant cancer treatments were reduced. We also noted a high reduction of emergency admissions such as myocardial infarction (38.7%), whereas the reduction in stroke admissions was smaller (19.6%). In contrast, we observed a considerable reduction in admissions for non-critical clinical situations, such as hysterectomies for benign tumors (78.8%) and hip replacements due to arthrosis (82.4%). In summary, our study shows that the university hospital admission rates in Germany were substantially reduced following the national COVID-19 lockdown. These included critical care or emergency conditions in which deferral is expected to impair clinical outcomes. Future studies are needed to delineate how appropriate medical care of critically ill patients can be maintained during a pandemic.

AB - The COVID-19 pandemic has caused strains on health systems worldwide disrupting routine hospital services for all non-COVID patients. Within this retrospective study, we analyzed inpatient hospital admissions across 18 German university hospitals during the 2020 lockdown period compared to 2018. Patients admitted to hospital between January 1 and May 31, 2020 and the corresponding periods in 2018 and 2019 were included in this study. Data derived from electronic health records were collected and analyzed using the data integration center infrastructure implemented in the university hospitals that are part of the four consortia funded by the German Medical Informatics Initiative. Admissions were grouped and counted by ICD 10 chapters and specific reasons for treatment at each site. Pooled aggregated data were centrally analyzed with descriptive statistics to compare absolute and relative differences between time periods of different years. The results illustrate how care process adoptions depended on the COVID-19 epidemiological situation and the criticality of the disease. Overall inpatient hospital admissions decreased by 35% in weeks 1 to 4 and by 30.3% in weeks 5 to 8 after the lockdown announcement compared to 2018. Even hospital admissions for critical care conditions such as malignant cancer treatments were reduced. We also noted a high reduction of emergency admissions such as myocardial infarction (38.7%), whereas the reduction in stroke admissions was smaller (19.6%). In contrast, we observed a considerable reduction in admissions for non-critical clinical situations, such as hysterectomies for benign tumors (78.8%) and hip replacements due to arthrosis (82.4%). In summary, our study shows that the university hospital admission rates in Germany were substantially reduced following the national COVID-19 lockdown. These included critical care or emergency conditions in which deferral is expected to impair clinical outcomes. Future studies are needed to delineate how appropriate medical care of critically ill patients can be maintained during a pandemic.

UR - https://www.frontiersin.org/articles/10.3389/fpubh.2020.594117/full

U2 - 10.3389/fpubh.2020.594117

DO - 10.3389/fpubh.2020.594117

M3 - SCORING: Journal article

VL - 8

SP - 594117

JO - FRONT PUBLIC HEALTH

JF - FRONT PUBLIC HEALTH

SN - 2296-2565

IS - 1018

M1 - 594117

ER -