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

被引：83

作者：

Kapsner, Lorenz A. ^{[1
,2
]}

Kampf, Marvin O. ^{[1
]}

Seuchter, Susanne A. ^{[1
]}

Gruendner, Julian ^{[3
]}

Gulden, Christian ^{[3
]}

Mate, Sebastian ^{[1
]}

Mang, Jonathan M. ^{[1
]}

Schuettler, Christina ^{[3
]}

Deppenwiese, Noemi ^{[3
]}

Krause, Linda ^{[4
]}

Zoeller, Daniela ^{[5
,6
]}

Balig, Julien ^{[7
]}

Fuchs, Timo ^{[8
]}

Fischer, Patrick ^{[9
]}

Haverkamp, Christian ^{[6
,10
]}

Holderried, Martin ^{[11
]}

Mayer, Gerhard ^{[7
]}

Stenzhorn, Holger ^{[12
,13
]}

Stolnicu, Ana ^{[7
]}

Storck, Michael ^{[14
]}

Storf, Holger ^{[15
]}

Zohner, Jochen ^{[9
]}

Kohlbacher, Oliver ^{[13
,16
,17
,18
]}

Strzelczyk, Adam ^{[19
]}

Schuettler, Juergen ^{[20
]}

Acker, Till ^{[21
]}

Boeker, Martin ^{[5
,6
]}

Kaisers, Udo X. ^{[22
]}

Kestler, Hans A. ^{[7
]}

Prokosch, Hans-Ulrich ^{[3
]}

机构：

[1] Univ Klinikum Erlangen, Med Ctr Informat & Commun Technol, Erlangen, Germany

[2] Friedrich Alexander Univ Erlangen Nurnberg FAU, Univ Klinikum Erlangen, Dept Radiol, Erlangen, Germany

[3] Friedrich Alexander Univ Erlangen Nurnberg FAU, Chair Med Informat, Erlangen, Germany

[4] Univ Med Ctr Hamburg Eppendorf, Inst Med Biometry & Epidemiol, Hamburg, Germany

[5] Univ Freiburg, Fac Med, Inst Med Biometry & Stat, Freiburg, Germany

[6] Univ Freiburg, Med Ctr, Freiburg, Germany

[7] Ulm Univ, Inst Med Syst Biol, Ulm, Germany

[8] Univ Hosp Regensburg, Dept Nucl Med, Regensburg, Germany

[9] Justus Liebig Univ, Fac Med, Inst Med Informat, Giessen, Germany

[10] Univ Freiburg, Inst Digitalisat Med, Fac Med, Freiburg, Germany

[11] Univ Hosp Tubingen, Dept Med Dev & Qual Management, Tubingen, Germany

[12] Saarland Univ, Med Ctr, Inst Med Biometry Epidemiol & Med Informat, Homburg, Germany

[13] Univ Hosp Tubingen, Inst Translat Bioinformat, Tubingen, Germany

[14] Univ Munster, Inst Med Informat, Munster, Germany

[15] Univ Klinikum Frankfurt, Med Informat Grp, Frankfurt, Germany

[16] Univ Tubingen, Dept Comp Sci, Appl Bioinformat, Tubingen, Germany

[17] Univ Tubingen, Inst Bioinformat & Med Informat, Tubingen, Germany

[18] Max Planck Inst Dev Biol, Biomol Interact, Tubingen, Germany

[19] Goethe Univ Frankfurt, Ctr Neurol & Neurosurg, Epilepsy Ctr Frankfurt Rhine Main, Frankfurt, Germany

[20] Univ Hosp Erlangen, Dept Anesthesiol, Erlangen, Germany

[21] Justus Liebig Univ, Inst Neuropathol, Giessen, Germany

[22] Ulm Univ, Med Ctr, Ulm, Germany

来源：

FRONTIERS IN PUBLIC HEALTH | 2021年 / 8卷

关键词：

COVID-19; pandemic; healthcare systems; inpatient hospital admissions; Germany; medical informatics initiative; lockdown; university hospitals; MIRACUM MEDICAL INFORMATICS; DATA INTEGRATION; CARE;

D O I：

10.3389/fpubh.2020.594117

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

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.

引用

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