Disruption of hospital care during the first year of the COVID-19 pandemic impacted socioeconomic groups differently: population based study using routine registration data
Abstract Background During the COVID-19 pandemic, provision of non-COVID healthcare was recurrently severely disrupted. The objective was to determine whether disruption of non-COVID hospital use, either due to cancelled, postponed, or forgone care, during the first pandemic year of COVID-19 impacte...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-024-10695-9 |
| _version_ | 1827321511999963136 |
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| author | Tessa Jansen Sigur Gouwens Lotta Meijerink Iris Meulman Lisanne H. J. A. Kouwenberg G. Ardine de Wit Johan J. Polder Anton E. Kunst Ellen Uiters |
| author_facet | Tessa Jansen Sigur Gouwens Lotta Meijerink Iris Meulman Lisanne H. J. A. Kouwenberg G. Ardine de Wit Johan J. Polder Anton E. Kunst Ellen Uiters |
| author_sort | Tessa Jansen |
| collection | DOAJ |
| description | Abstract Background During the COVID-19 pandemic, provision of non-COVID healthcare was recurrently severely disrupted. The objective was to determine whether disruption of non-COVID hospital use, either due to cancelled, postponed, or forgone care, during the first pandemic year of COVID-19 impacted socioeconomic groups differently compared with pre-pandemic use. Methods National population registry data, individually linked with data of non-COVID hospital use in the Netherlands (2017–2020). in non-institutionalised population of 25–79 years, in standardised household income deciles (1 = low, 10 = high) as proxy for socioeconomic status. Generic outcome measures included patients who received hospital care (dichotomous): outpatient contact, day treatment, inpatient clinic, and surgery. Specific procedures were included as examples of frequently performed elective and acute procedures, e.g.: elective knee/hip replacement and cataract surgery, and acute percutaneous coronary interventions (PCI). Relative risks (RR) for hospital use were reported as outcomes from generalised linear regression models (binomial) with log-link. An interaction term was included to assess whether income differences in hospital use during the pandemic deviated from pre-pandemic use. Results Hospital use rates declined in 2020 across all income groups. With baseline (2019) higher hospital use rates among lower than higher income groups, relatively stronger declines were found for lower income groups. The lowest income groups experienced a 10% larger decline in surgery received than the highest income group (RR 0.90, 95% CI 0.87 – 0.93). Patterns were similar for inpatient clinic, elective knee/hip replacement and cataract surgery. We found small or no significant income differences for outpatient clinic, day treatment, and acute PCI. Conclusions Disruption of non-COVID hospital use in 2020 was substantial across all income groups during the acute phases of the pandemic, but relatively stronger for lower income groups than could be expected compared with pre-pandemic hospital use. Although the pandemic’s impact on the health system was unprecedented, healthcare service shortages are here to stay. It is therefore pivotal to realise that lower income groups may be at risk for underuse in times of scarcity. |
| first_indexed | 2024-04-25T01:07:27Z |
| format | Article |
| id | doaj.art-b8bb40934e174f81a23df34f5398df0c |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-04-25T01:07:27Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-b8bb40934e174f81a23df34f5398df0c2024-03-10T12:09:06ZengBMCBMC Health Services Research1472-69632024-03-0124111210.1186/s12913-024-10695-9Disruption of hospital care during the first year of the COVID-19 pandemic impacted socioeconomic groups differently: population based study using routine registration dataTessa Jansen0Sigur Gouwens1Lotta Meijerink2Iris Meulman3Lisanne H. J. A. Kouwenberg4G. Ardine de Wit5Johan J. Polder6Anton E. Kunst7Ellen Uiters8Centre for Public Health, Healthcare, and Society, National Institute for Public Health and the Environment (RIVM)Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg UniversityTranzo, Tilburg School of Social and Behavioral Sciences, Tilburg UniversityTranzo, Tilburg School of Social and Behavioral Sciences, Tilburg UniversityCentre for Public Health, Healthcare, and Society, National Institute for Public Health and the Environment (RIVM)Centre for Public Health, Healthcare, and Society, National Institute for Public Health and the Environment (RIVM)Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg UniversityDepartment of Health Sciences, Faculty of Science & Amsterdam Public Health Research Institute, Vrije Universiteit AmsterdamCentre for Public Health, Healthcare, and Society, National Institute for Public Health and the Environment (RIVM)Abstract Background During the COVID-19 pandemic, provision of non-COVID healthcare was recurrently severely disrupted. The objective was to determine whether disruption of non-COVID hospital use, either due to cancelled, postponed, or forgone care, during the first pandemic year of COVID-19 impacted socioeconomic groups differently compared with pre-pandemic use. Methods National population registry data, individually linked with data of non-COVID hospital use in the Netherlands (2017–2020). in non-institutionalised population of 25–79 years, in standardised household income deciles (1 = low, 10 = high) as proxy for socioeconomic status. Generic outcome measures included patients who received hospital care (dichotomous): outpatient contact, day treatment, inpatient clinic, and surgery. Specific procedures were included as examples of frequently performed elective and acute procedures, e.g.: elective knee/hip replacement and cataract surgery, and acute percutaneous coronary interventions (PCI). Relative risks (RR) for hospital use were reported as outcomes from generalised linear regression models (binomial) with log-link. An interaction term was included to assess whether income differences in hospital use during the pandemic deviated from pre-pandemic use. Results Hospital use rates declined in 2020 across all income groups. With baseline (2019) higher hospital use rates among lower than higher income groups, relatively stronger declines were found for lower income groups. The lowest income groups experienced a 10% larger decline in surgery received than the highest income group (RR 0.90, 95% CI 0.87 – 0.93). Patterns were similar for inpatient clinic, elective knee/hip replacement and cataract surgery. We found small or no significant income differences for outpatient clinic, day treatment, and acute PCI. Conclusions Disruption of non-COVID hospital use in 2020 was substantial across all income groups during the acute phases of the pandemic, but relatively stronger for lower income groups than could be expected compared with pre-pandemic hospital use. Although the pandemic’s impact on the health system was unprecedented, healthcare service shortages are here to stay. It is therefore pivotal to realise that lower income groups may be at risk for underuse in times of scarcity.https://doi.org/10.1186/s12913-024-10695-9COVID-19Healthcare disparitiesSocioeconomic factorsHealth services |
| spellingShingle | Tessa Jansen Sigur Gouwens Lotta Meijerink Iris Meulman Lisanne H. J. A. Kouwenberg G. Ardine de Wit Johan J. Polder Anton E. Kunst Ellen Uiters Disruption of hospital care during the first year of the COVID-19 pandemic impacted socioeconomic groups differently: population based study using routine registration data BMC Health Services Research COVID-19 Healthcare disparities Socioeconomic factors Health services |
| title | Disruption of hospital care during the first year of the COVID-19 pandemic impacted socioeconomic groups differently: population based study using routine registration data |
| title_full | Disruption of hospital care during the first year of the COVID-19 pandemic impacted socioeconomic groups differently: population based study using routine registration data |
| title_fullStr | Disruption of hospital care during the first year of the COVID-19 pandemic impacted socioeconomic groups differently: population based study using routine registration data |
| title_full_unstemmed | Disruption of hospital care during the first year of the COVID-19 pandemic impacted socioeconomic groups differently: population based study using routine registration data |
| title_short | Disruption of hospital care during the first year of the COVID-19 pandemic impacted socioeconomic groups differently: population based study using routine registration data |
| title_sort | disruption of hospital care during the first year of the covid 19 pandemic impacted socioeconomic groups differently population based study using routine registration data |
| topic | COVID-19 Healthcare disparities Socioeconomic factors Health services |
| url | https://doi.org/10.1186/s12913-024-10695-9 |
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