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Front Public Health

Title:		Reduced Rate of Inpatient Hospital Admissions in 18 German University Hospitals During the COVID-19 Lockdown
Author(s):		Kapsner LA; Kampf MO; Seuchter SA; Gruendner J; Gulden C; Mate S; Mang JM; Schuttler C; Deppenwiese N; Krause L; Zoller D; Balig J; Fuchs T; Fischer P; Haverkamp C; Holderried M; Mayer G; Stenzhorn H; Stolnicu A; Storck M; Storf H; Zohner J; Kohlbacher O; Strzelczyk A; Schuttler J; Acker T; Boeker M; Kaisers UX; Kestler HA; Prokosch HU;
Address:		"Medical Center for Information and Communication Technology, Universitatsklinikum Erlangen, Erlangen, Germany. Department of Radiology, Universitatsklinikum Erlangen, Friedrich-Alexander-Universitat Erlangen-Nurnberg (FAU), Erlangen, Germany. Chair of Medical Informatics, Friedrich-Alexander-Universitat Erlangen-Nurnberg (FAU), Erlangen, 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 Systems Biology, Ulm University, Ulm, Germany. Department of Nuclear Medicine, University Hospital Regensburg, Regensburg, Germany. Institute of Medical Informatics, Faculty of Medicine, Justus-Liebig-University, Giessen, Germany. Institute of Digitalisation in Medicine, Medical Faculty and Medical Center, University of Freiburg, Freiburg, Germany. Department of Medical Development and Quality Management, University Hospital Tubingen, Tubingen, Germany. Saarland University Medical Center, Institute for Medical Biometry, Epidemiology and Medical Informatics, Homburg, Germany. Institute for Translational Bioinformatics, University Hospital Tubingen, Tubingen, Germany. Institute of Medical Informatics, University of Munster, Munster, Germany. Medical Informatics Group, Universitatsklinikum Frankfurt, Frankfurt, Germany. Applied Bioinformatics, Department of Computer Science, University of Tubingen, Tubingen, Germany. Institute for Bioinformatics and Medical Informatics, University of Tubingen, Tubingen, Germany. Biomolecular Interactions, Max Planck Institute for Developmental Biology, Tubingen, Germany. Epilepsy Center Frankfurt Rhine-Main, Center of Neurology and Neurosurgery, Goethe University Frankfurt, Frankfurt, Germany. Department of Anesthesiology, University Hospital Erlangen, Erlangen, Germany. Institute of Neuropathology, Justus-Liebig-University, Giessen, Germany. Ulm University Medical Center, Ulm, Germany"
Journal Title:		Front Public Health
Year:		2020
Volume:		20210113
Issue:
Page Number:		594117 -
DOI:		10.3389/fpubh.2020.594117
ISSN/ISBN:		2296-2565 (Electronic) 2296-2565 (Linking)
Abstract:		"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"
Keywords:		"COVID-19/*epidemiology Emergency Service, Hospital/*statistics & numerical data/trends Forecasting Germany/epidemiology Hospitalization/*statistics & numerical data/trends Hospitals, University/*statistics & numerical data/trends Humans Pandemics/*statist;"
Notes:		"MedlineKapsner, Lorenz A Kampf, Marvin O Seuchter, Susanne A Gruendner, Julian Gulden, Christian Mate, Sebastian Mang, Jonathan M Schuttler, Christina Deppenwiese, Noemi Krause, Linda Zoller, Daniela Balig, Julien Fuchs, Timo Fischer, Patrick Haverkamp, Christian Holderried, Martin Mayer, Gerhard Stenzhorn, Holger Stolnicu, Ana Storck, Michael Storf, Holger Zohner, Jochen Kohlbacher, Oliver Strzelczyk, Adam Schuttler, Jurgen Acker, Till Boeker, Martin Kaisers, Udo X Kestler, Hans A Prokosch, Hans-Ulrich eng Comparative Study Research Support, Non-U.S. Gov't Switzerland 2021/02/02 Front Public Health. 2021 Jan 13; 8:594117. doi: 10.3389/fpubh.2020.594117. eCollection 2020"