F Lucy Wright
Effects of the COVID-19 pandemic on secondary care for cardiovascular disease in the UK: an electronic health record analysis across three countries.
Wright, F Lucy; Cheema, Kate; Goldacre, Raph; Hall, Nick; Herz, Naomi; Islam, Nazrul; Karim, Zainab; Moreno-Martos, David; Morales, Daniel R; O'Connell, Daniel; Spata, Enti; Akbari, Ashley; Ashworth, Mark; Barber, Mark; Briffa, Norman; Canoy, Dexter; Denaxas, Spiros; Khunti, Kamlesh; Kurdi, Amanj; Mamas, Mamas; Priedon, Rouven; Sudlow, Cathie; Morris, Eva J A; Lacey, Ben; Banerjee, Amitava
Authors
Kate Cheema
Raph Goldacre
Nick Hall
Naomi Herz
Nazrul Islam
Zainab Karim
David Moreno-Martos
Daniel R Morales
Daniel O'Connell
Enti Spata
Ashley Akbari
Mark Ashworth
Mark Barber
Norman Briffa
Dexter Canoy
Spiros Denaxas
Kamlesh Khunti
Amanj Kurdi
Mamas Mamas m.mamas@keele.ac.uk
Rouven Priedon
Cathie Sudlow
Eva J A Morris
Ben Lacey
Amitava Banerjee
Abstract
BACKGROUND: Although morbidity and mortality from COVID-19 have been widely reported, the indirect effects of the pandemic beyond 2020 on other major diseases and health service activity have not been well described. METHODS: Analyses used national administrative electronic hospital records in England, Scotland and Wales for 2016-2021. Admissions and procedures during the pandemic (2020-2021) related to six major cardiovascular conditions (acute coronary syndrome, heart failure, stroke/transient ischaemic attack, peripheral arterial disease, aortic aneurysm, and venous thromboembolism) were compared to the annual average in the pre-pandemic period (2016-2019). Differences were assessed by time period and urgency of care. RESULTS: In 2020, there were 31 064 (-6%) fewer hospital admissions (14 506 [-4%] fewer emergencies, 16 560 [-23%] fewer elective admissions) compared to 2016-2019 for the six major cardiovascular diseases combined. The proportional reduction in admissions was similar in all three countries. Overall, hospital admissions returned to pre-pandemic levels in 2021. Elective admissions remained substantially below expected levels for almost all conditions in all three countries (-10 996 [-15%] fewer admissions). However, these reductions were offset by higher than expected total emergency admissions (+25 878 [+6%] higher admissions), notably for heart failure and stroke in England, and for venous thromboembolism in all three countries. Analyses for procedures showed similar temporal variations to admissions. CONCLUSION: This study highlights increasing emergency cardiovascular admissions during the pandemic, in the context of a substantial and sustained reduction in elective admissions and procedures. This is likely to increase further the demands on cardiovascular services over the coming years.
Journal Article Type | Article |
---|---|
Acceptance Date | Nov 14, 2022 |
Online Publication Date | Nov 16, 2022 |
Publication Date | 2023-06 |
Publicly Available Date | Mar 28, 2024 |
Journal | European Heart Journal - Quality of Care and Clinical Outcomes |
Print ISSN | 2058-5225 |
Publisher | Oxford University Press |
Peer Reviewed | Peer Reviewed |
Volume | 9 |
Issue | 4 |
DOI | https://doi.org/10.1093/ehjqcco/qcac077 |
Keywords | Cardiology and Cardiovascular Medicine, Health Policy |
Publisher URL | https://academic.oup.com/ehjqcco/advance-article/doi/10.1093/ehjqcco/qcac077/6831631 |
Files
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Publisher Licence URL
https://creativecommons.org/licenses/by-nc/4.0/
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