Integrative Spinal Research Group, Department of Chiropractic Medicine, Balgrist University Hospital and University of Zurich, Zurich, Switzerland.
Winterthur Institute of Health Economics, School of Management and Law, Zurich University of Applied Sciences, Winterthur, Switzerland.
PLoS One. 2024 Jul 8;19(7):e0306791. doi: 10.1371/journal.pone.0306791. eCollection 2024.
As part of the Covid-19-restrictions in Switzerland, a federal ban on non-urgent examinations and treatments was applied to all hospitals during six weeks in spring 2020 ("spring lockdown"). The aim of this study was to comprehensively investigate the consequences of the Covid-19 pandemic on Swiss inpatient admissions based on data of all hospitals, focusing on selected procedures of different medical urgency.
The study includes all acute care inpatient cases (including Covid-19 cases, excluding cases in psychiatry and rehabilitation) according to the Swiss Medical Statistics of Hospitals. Besides the total number of admissions, subdivided by regions, hospital types and age groups, we focused on selected procedures representing different medical urgency: elective surgeries, cancer surgeries, and emergencies. Procedures were selected based on expert interviews. We compared the number of admissions during spring lockdown and for the whole years 2020 and 2021 in absolute numbers and in percentage changes to the corresponding periods in 2019 (baseline year).
During spring lockdown, the number of admissions decreased by 47,156 (32.2%) without catch-up effect by the end of 2020 (-72,817 admissions/-5.8%). With procedure-specific decreases of up to 86%, the decline in admissions was largest for elective surgery, a decline that was only fully reversed in the case of a few procedures, such as joint arthroplasty. Strikingly, admissions due to emergencies also substantially decreased during spring lockdown (stroke -14%; acute myocardial infarction STEMI: -9%, NSTEMI: -26%). Results for the selected procedures in cancer surgery showed no consistent pattern. In 2021, admission numbers for most procedures reached or even exceeded those in 2019.
The substantial reduction in admissions, particularly in elective procedures, may reflect the impact of the triage in favor of anticipated Covid-19-cases during spring lockdown. By the end of 2020, admissions were still at lower levels relative to the previous, pre-pandemic year. The numbers in 2021 reached the same levels as those in 2019, which suggests that the Covid-19 pandemic only temporarily impacted inpatient health care in Switzerland. Long-term consequences of the observed reduction in admissions for emergencies and cancer surgery need to be investigated at the individual level.
作为瑞士新冠疫情限制措施的一部分，2020 年春季，联邦政府对所有医院实施了为期六周的非紧急检查和治疗禁令（“春季封锁”）。本研究旨在根据所有医院的数据，全面调查新冠疫情对瑞士住院患者的影响，重点关注不同医疗紧急程度的选定程序。
本研究包括根据瑞士医院医疗统计数据的所有急性护理住院病例（不包括精神病和康复科病例）。除了按地区、医院类型和年龄组细分的总入院人数外，我们还重点关注代表不同医疗紧急程度的选定程序：择期手术、癌症手术和急诊。根据专家访谈选择手术程序。我们将春季封锁期间以及 2020 年和 2021 年全年的入院人数与 2019 年（基线年）同期的绝对数量和百分比变化进行了比较。
在春季封锁期间，入院人数减少了 47,156 人（32.2%），到 2020 年底没有出现追赶效应（减少了 72,817 人，减少了 5.8%）。由于择期手术的降幅高达 86%，住院人数的降幅最大，只有少数手术（如关节置换术）完全逆转。令人惊讶的是，春季封锁期间急诊入院人数也大幅下降（中风 -14%；急性心肌梗死 STEMI：-9%，NSTEMI：-26%）。癌症手术中选定程序的结果没有呈现出一致的模式。2021 年，大多数程序的入院人数达到甚至超过了 2019 年的水平。
入院人数的大幅减少，特别是择期手术的减少，可能反映了春季封锁期间为预期的新冠病例进行分诊的影响。到 2020 年底，与前一年即大流行前的水平相比，入院人数仍然较低。2021 年的数字达到了 2019 年的水平，这表明新冠疫情仅对瑞士的住院医疗服务产生了暂时的影响。需要在个体层面上调查观察到的急诊和癌症手术入院人数减少的长期后果。
