Impact of the COVID-19 Pandemic on Elective and Emergency Inpatient Procedure Volumes in Switzerland – A Retrospective Study Based on Insurance Claims Data

Abstract

Background The severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) pandemic forced hospitals to redistribute resources for the treatment of patients with coronavirus disease 2019 (COVID‑19), yet the impact on elective and emergency inpatient procedure volumes is unclear.Methods We analyzed anonymized data on 234 921 hospitalizations in 2017‑2020 (55.9% elective) from a big Swiss health insurer. We used linear regression models to predict, based on pre‑pandemic data, the expected weekly numbers of procedures in 2020 in the absence of a pandemic and compared these to the observed numbers in 2020. Compensation effects were investigated by discretely integrating the difference between the two numbers over time.Results During the first COVID‑19 wave in spring 2020, elective procedure numbers decreased by 52.9% (95% confidence interval ‑64.5% to ‑42.5%), with cardiovascular and orthopedic elective procedure numbers specifically decreasing by 45.5% and 72.4%. Elective procedure numbers normalized during summer with some compensation of postponed procedures, leaving a deficit of ‑9.9% (‑15.8% to ‑4.5%) for the whole year 2020. Emergency procedure numbers also decreased by 17.1% (‑23.7% to ‑9.8%) during the first wave, but over the whole year 2020, net emergency procedure volumes were similar to control years.Conclusion Inpatient procedure volumes in Switzerland decreased considerably in the beginning of the pandemic but recovered quickly after the first wave. Still, there was a net deficit in procedures at the end of the year. Health system leaders must work to ensure that adequate access to non‑COVID‑19 related care is maintained during future pandemic phases in order to prevent negative health consequences.

Keywords

• covid‑19
• inpatient
• hospitals
• surgery
• undertreatment
• switzerland