Impact of COVID-19 on hospitalisation for diverse conditions in European countries

Abstract Background The COVID-19 pandemic has had an unprecedented impact on Europe. Health systems came under strain, with non-urgent treatments postponed and resources reserved for treatment of COVID-19 patients. Delayed care seeking has been reported, for fear of infection with SARS-CoV2. Yet, the scale of this impact remains under researched. This study aims to compare indirect effects of the pandemic in a European cross-country study aiming to highlight the potential of Population Health Information Research Infrastructures (www.phiri.eu). Methods Focusing on (i) major vascular events (MVE) and (ii) elective surgery for joint replacements (ESJR) as well as (iii) serious trauma this study analyses individual level hospital data in a standardised harmonised data model. We compared pre-pandemic incidence rates (2018-2019) with rates for 2020 and 2021. Analyses are systematically contrasted with SARS CoV2 incidence rates, and policy measures taken based on the OxCGRT index. Results A drop in hospital discharge rates was observed during the pandemic in all countries but differing by condition and month. Socio-economic differences also varied by condition. Our evidence suggests that periods of more severe policy measures also correlated with more dramatic drops in regular hospital activities. Conclusions Our findings provide new insights on the dramatic level of de-prioritisation of essential services faced by non-COVID-19 patients in Europe. From a public health perspective, hospital escalation plans should be developed early on to avoid negative mid and long-term health and financial consequences of indirect effects. The study demonstrates the tremendous potential in exploiting health information systems in a systematic way across countries and the value of the PHIRI system. Further research should investigate policy trade-offs involved in severe lockdown measures during a pandemic and variations in health service resilience for future pandemic preparedness.


Background:
The COVID-19 pandemic has had an unprecedented impact on Europe.Health systems came under strain, with non-urgent treatments postponed and resources reserved for treatment of COVID-19 patients.Delayed care seeking has been reported, for fear of infection with SARS-CoV2.Yet, the scale of this impact remains under researched.This study aims to compare indirect effects of the pandemic in a European cross-country study aiming to highlight the potential of Population Health Information Research Infrastructures (www.phiri.eu).

Methods:
Focusing on (i) major vascular events (MVE) and (ii) elective surgery for joint replacements (ESJR) as well as (iii) serious trauma this study analyses individual level hospital data in a standardised harmonised data model.We compared prepandemic incidence rates (2018-2019) with rates for 2020 and 2021.Analyses are systematically contrasted with SARS CoV2 incidence rates, and policy measures taken based on the OxCGRT index.

Results:
A drop in hospital discharge rates was observed during the pandemic in all countries but differing by condition and 15th European Public Health Conference 2022 month.Socio-economic differences also varied by condition.Our evidence suggests that periods of more severe policy measures also correlated with more dramatic drops in regular hospital activities.

Conclusions:
Our findings provide new insights on the dramatic level of deprioritisation of essential services faced by non-COVID-19 patients in Europe.From a public health perspective, hospital escalation plans should be developed early on to avoid negative mid and long-term health and financial consequences of indirect effects.The study demonstrates the tremendous potential in exploiting health information systems in a systematic way across countries and the value of the PHIRI system.Further research should investigate policy trade-offs involved in severe lockdown measures during a pandemic and variations in health service resilience for future pandemic preparedness.

Background:
The COVID-19 pandemic and lockdowns may adversely affect pregnancy outcomes due to disrupted healthcare provision and increased stress, anxiety and economic hardship.We assessed changes in perinatal outcomes in 2020 using population birth data in Europe.Methods: 25 Countries in the Euro-Peristat Network implemented a federated analysis using routine national data.Countries generated anonymised aggregate data files using R scripts from individual-level data formatted to a common data model with 22 variables.We compared preterm birth, stillbirth, neonatal death and caesarean delivery rates in 2020 to 2015-2019 for 2 periods: full-year (FY) and pandemic (March-September [MS]).Data from October onward were not included in the MS period because potentially declining pandemic-related fertility may affect perinatal indicators.Country-specific relative risks (RR) for the periods, adjusted for linear trends, overall and by socio-economic (SES) group, were calculated and pooled using random effects metaanalysis.

Conclusions:
In 2020, there was an unexpected decline in preterm birth in some countries, while increases in stillbirths and caesarean occurred in others.High country-level heterogeneity suggests that some government policies to mitigate the pandemic might have been more protective of pregnant women and newborns than others.