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

Frontiers in Public Health

Noemi Deppenwiese¹  Christina Schüttler¹  Julian Gruendner¹  Christian Gulden¹  Hans-Ulrich Prokosch¹  Jürgen Schüttler²  Martin Holderried³  Timo Fuchs⁴  Adam Strzelczyk⁵  Oliver Kohlbacher⁶  Christian Haverkamp⁷  Linda Krause⁸  Daniela Zöller⁹  Martin Boeker⁹  Jochen Zohner^1,10  Patrick Fischer^1,10  Michael Storck^1,11  Gerhard Mayer^1,12  Julien Balig^1,12  Ana Stolnicu^1,12  Hans A. Kestler^1,12  Till Acker^1,13  Jonathan M. Mang^1,14  Susanne A. Seuchter^1,14  Sebastian Mate^1,14  Marvin O. Kampf^1,14  Lorenz A. Kapsner^1,15  Holger Storf^1,16  Holger Stenzhorn^1,17  Udo X. Kaisers^1,18 

[1] Chair of Medical Informatics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany;Department of Anesthesiology, University Hospital Erlangen, Erlangen, Germany;Department of Medical Development and Quality Management, University Hospital Tübingen, Tübingen, Germany;Department of Nuclear Medicine, University Hospital Regensburg, Regensburg, Germany;Epilepsy Center Frankfurt Rhine-Main, Center of Neurology and Neurosurgery, Goethe University Frankfurt, Frankfurt, Germany;Institute for Translational Bioinformatics, University Hospital Tübingen, Tübingen, Germany;Applied Bioinformatics, Department of Computer Science, University of Tübingen, Tübingen, Germany;Institute for Bioinformatics and Medical Informatics, University of Tübingen, Tübingen, Germany;Biomolecular Interactions, Max Planck Institute for Developmental Biology, Tübingen, Germany;Institute of Digitalisation in Medicine, Medical Faculty and Medical Center, University of Freiburg, Freiburg, Germany;Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;Institute of Medical Biometry and Statistics, Medical Faculty and Medical Center, University of Freiburg, Freiburg, Germany;Institute of Medical Informatics, Faculty of Medicine, Justus-Liebig-University, Gießen, Germany;Institute of Medical Informatics, University of Münster, Münster, Germany;Institute of Medical Systems Biology, Ulm University, Ulm, Germany;Institute of Neuropathology, Justus-Liebig-University, Gießen, Germany;Medical Center for Information and Communication Technology, Universitätsklinikum Erlangen, Erlangen, Germany;Medical Center for Information and Communication Technology, Universitätsklinikum Erlangen, Erlangen, Germany;Department of Radiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany;Medical Informatics Group, Universitätsklinikum Frankfurt, Frankfurt, Germany;Saarland University Medical Center, Institute for Medical Biometry, Epidemiology and Medical Informatics, Homburg, Germany;Institute for Translational Bioinformatics, University Hospital Tübingen, Tübingen, Germany;Ulm University Medical Center, Ulm, Germany;

关键词: COVID-19;    pandemic;    healthcare systems;    inpatient hospital admissions;    Germany;    medical informatics initiative;    lockdown;    university hospitals;   

DOI  :  10.3389/fpubh.2020.594117

来源: Frontiers

【 摘 要 】

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.

【 授权许可】

CC BY