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. 2024 Jul 1;34(Supplement_1):i67-i73.
doi: 10.1093/eurpub/ckad180.

Has the COVID-19 pandemic changed existing patterns of non-COVID-19 health care utilization? A retrospective analysis of six regions in Europe

Sarah J Aldridge  1 , Andrea E Schmidt  2 , Martin Thißen  3 , Enrique Bernal-Delgado  4 , Francisco Estupiñán-Romero  4 , Javier González-Galindo  4 , Lorenz Dolanski-Aghamanoukjan  5 , Stefan Mathis-Edenhofer  6 , Tamara Buble  7 , Klea Križ  7 , Jakov Vuković  7 , Luigi Palmieri  8 , Brigid Unim  8 , Iris Meulman  9   10 , Rhiannon K Owen  1 , Ronan A Lyons  1
Affiliations

Has the COVID-19 pandemic changed existing patterns of non-COVID-19 health care utilization? A retrospective analysis of six regions in Europe

Sarah J Aldridge et al. Eur J Public Health. .

Abstract

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.

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Figures

Figure 1
Figure 1
PHIRI standard workflow in the deployment of research questions
Figure 2
Figure 2
European age-standardized rates (solid lines) and the 95% CI (shaded area) across four selected forms of HCU in six regions in Europe
Figure 3
Figure 3
The forecasting results for heart attack in six regions of Europe. The dotted line indicates the start of 2020. The solid line indicates real data and the highlighted region is the 95% prediction intervals, representing the expected range of values generated by the model. All data before the dotted line were used to create the forecast model, and the red dots highlight data that deviated from the expected range
See this image and copyright information in PMC

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