scholarly journals Impacts of mild COVID-19 on elevated use of primary and specialist health care services: A nationwide register study from Norway

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0257926
Author(s):  
Katrine Damgaard Skyrud ◽  
Kjersti Helene Hernæs ◽  
Kjetil Elias Telle ◽  
Karin Magnusson
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Services ◽  
Age Groups ◽  
Relative Difference ◽  
Health Care Use ◽  
Positive Test ◽  
Specialist Care ◽  
Care Services ◽  
Specialist Health Care

Aim To explore the temporal impact of mild COVID-19 on need for primary and specialist health care services. Methods In all adults (≥20 years) tested for SARS-CoV-2 in Norway March 1st 2020 to February 1st 2021 (N = 1 401 922), we contrasted the monthly all-cause health care use before and up to 6 months after the test (% relative difference), for patients with a positive test for SARS-CoV-2 (non-hospitalization, i.e. mild COVID-19) and patients with a negative test (no COVID-19). Results We found a substantial short-term elevation in primary care use in all age groups, with men generally having a higher relative increase (men 20–44 years: 522%, 95%CI = 509–535, 45–69 years: 439%, 95%CI = 426–452, ≥70 years: 199%, 95%CI = 180–218) than women (20–44 years: 342, 95%CI = 334–350, 45–69 years = 375, 95%CI = 365–385, ≥70 years: 156%, 95%CI = 141–171) at 1 month following positive test. At 2 months, this sex difference was less pronounced, with a (20–44 years: 21%, 95%CI = 13–29, 45–69 years = 38%, 95%CI = 30–46, ≥70 years: 15%, 95%CI = 3–28) increase in primary care use for men, and a (20–44 years: 30%, 95%CI = 24–36, 45–69 years = 57%, 95%CI = 50–64, ≥70 years: 14%, 95%CI = 4–24) increase for women. At 3 months after test, only women aged 45–70 years still had an increased primary care use (14%, 95%CI = 7–20). The increase was due to respiratory- and general/unspecified conditions. We observed no long-term (4–6 months) elevation in primary care use, and no elevation in specialist care use. Conclusion Mild COVID-19 gives an elevated need for primary care that vanishes 2–3 months after positive test. Middle-aged women had the most prolonged increased primary care use.

scholarly journals Health care use up to 6 months after COVID-19 in 700.000 children and adolescents: a pre-post study

2021 ◽  
Author(s):  
Karin Magnusson ◽  
Katrine Damgaard Skyrud ◽  
Pal Suren ◽  
Margrethe Greve-Isdahl ◽  
Ketil Stordal ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Services ◽  
Age Groups ◽  
Health Care Use ◽  
School Age ◽  
Older Children ◽  
Specialist Care ◽  
Before And After ◽  
Specialist Health Care

Objectives: To explore whether, and for how long COVID-19 among children gives an increase in use of health care services, when compared to children with no COVID-19. Methods: Studying all Norwegian residents aged 1-5, 6-15 and 16-19 years from August 1st 2020 to February 1st 2021 (N= 768 560), we contrasted rates of monthly all-cause primary and specialist health care use before and after testing for SARS-CoV-2 (% relative change), for children testing positive (non-hospitalized in the acute phase) (N=10 306) vs children with no COVID-19 (N=758 254). Results: We found a substantial elevation in short-term primary care use for children testing positive for SARS-CoV-2 during the first month following positive test when compared to children testing negative (relative elevation 1-5 years: 325%, 95%CI=296-354; 6-15 years: 434%, 95%CI=415-453; 16-19 years: 360%, 95%CI=342-379). There was still elevated primary care use at 2 months (1-5 years: 21%, 95%CI= 4-38; 6-15 years: 13%, 95%CI=2-25) and at 3 months (1-5 years: 26%, 95%CI=7-45, 6-15 years: 15%, 95%CI=3-26) for young children, but not at 2 or 3 months for the older children (16-19 years: 10%, 95%CI=-1-22 and 6%, 95%CI=-5-18, respectively). The 1-5-year-olds also had a long-term (up to 6 months) increase of primary care (14%, 95%CI=1-26) that was not observed for older age groups, when compared to same-aged children testing negative. We observed no elevated use of specialist care. Conclusion: Children in pre-school age used health services for a longer time (3-6 months) after COVID-19 than children in primary and secondary school age (1-3 months).

scholarly journals Pandemic trends in health care use: From the hospital bed to the general practitioner with COVID-19

2021 ◽  
Author(s):  
Fredrik Methi ◽  
Kjersti Helene Hernaes ◽  
Katrine Damgaard Skyrud ◽  
Karin Magnusson
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Age Groups ◽  
Health Care Use ◽  
Specialist Care ◽  
Care Services ◽  
Primary Care Services ◽  
Hospital Bed ◽  
Bed Days ◽  
The Mean

Aim: To explore whether the acute 30-day burden of COVID-19 on health care use has changed from the beginning to the end of the pandemic. Methods: In all Norwegians (N=122 699) who tested positive for SARS-CoV-2 in three pandemic waves (March 1st-July 31st 2020 (1st wave), August 1st-December 31st 2020 (2nd wave), and January 1st-May 31st 2021 (3rd wave)), we studied the age- and sex-specific share of patients (by age groups 1-19, 20-67, and 68 or more) who had: 1) Relied on self-care, 2) used primary care, and 3) used specialist care. Results: We find that a remarkably high and stable share (70-80%) of patients with COVID-19 exclusively had contact with primary care in the acute phase, both in the 1st, 2nd and 3rd wave. The mean number of primary care visits ranged between 2 and 4. We also show that the use of specialist care in the acute 30-day phase of COVID-19 has decreased, from 14% being hospitalized at least once during spring 2020, to 4% during spring 2021. The mean number of hospital bed-days decreased significantly for men from the 1st to the 2nd wave (from 13 days, 95% CI=11.5-14.5 to 10 days (9-11) for men aged ≥68 years, and from 11 days (10-12) to 9 days (8-10) for men aged 20-67 years), but not for women. Conclusion: COVID-19 places a continued high demand on the primary care services, and a decreasing demand on the specialist care services.

scholarly journals Impacts of COVID-19 on long-term health and health care use

2021 ◽  
Author(s):  
Katrine Skyrud ◽  
Kjetil Telle ◽  
Karin Magnusson
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Use ◽  
Positive Test ◽  
Specialist Care ◽  
Positive Health ◽  
Before And After ◽  
Specialist Health Care ◽  
Respiratory Conditions

AimTo explore impacts of mild and severe COVID-19 on acute and long-term utilization of primary care, inpatient- and outpatient specialist health care.MethodsIn all persons tested for the SARS-CoV-2 in Norway March 1st to November 1st 2020 (N=1 257 831), we used a difference-in-differences design to contrast the monthly health care use before and after testing, across patients with negative test (no COVID-19) and 1) positive test, not hospitalized (mild COVID-19) and 2) positive test, hospitalized (severe COVID-19). We studied all-cause- and cause-specific health care use for digestive, circulatory, respiratory, endocrine/metabolic/nutritional, genitourinary, eye/ear, musculoskeletal, mental, skin, blood and general/unspecified conditions.ResultsMild COVID-19 impacted on primary care due to respiratory conditions at 0-3 months after having tested positive (786% increase). Severe COVID-19 impacted on visits due to respiratory-(337-3316% increase), circulatory-(166-205% increase), endocrine/metabolic/nutritional-(168-791% increase) as well as visits due to general/unspecified conditions (48-431% increase) in outpatient and inpatient specialist care 0-3 months after being tested. Severe COVID-19 also impacted on outpatient specialist care after 4-6 months, for respiratory and circulatory conditions (199-246% increase) and general/unspecified conditions (40% increase).ConclusionOur findings imply that mild COVID-19 does not persist to cause a need for health care beyond two months after having tested positive. Health care contacts increased the most in specialist care for those who had undergone severe COVID-19, both at 0-3 and at 4-6 months. This increase was due to respiratory, circulatory, endocrine/metabolic/nutritional and general/unspecified causes.

scholarly journals Utilization of health care services before and after media attention about fatal side effects of the AstraZeneca vaccine

2021 ◽  
Author(s):  
Vilde Bergstad Larsen ◽  
Mari Grøsland ◽  
Kjetil Elias Telle ◽  
Karin Magnusson
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Side Effects ◽  
Health Care Services ◽  
Comparison Group ◽  
Health Care Use ◽  
Specialist Care ◽  
Care Services ◽  
Primary Health ◽  
Care Workers

Objective: To assess whether utilization of health care services for newly vaccinated health care workers changed after media attention about fatal side effects of the AstraZeneca vaccine on March 11th, 2021, and whether changes differed by age, sex, or occupation. Data sources: We utilized individual-level data on health care use, vaccination, employment, and demographics available in the Norwegian emergency preparedness register BeredtC19. Study design: Using an event-study design with a matched comparison group and multiple time periods, we compared the change in primary and inpatient specialist care use for vaccinated health care workers from 14 days before to 14 days after the information shock on March 11th, 2021. Data collection: Not applicable. Principal findings: Primary health care use rose sharply by 66% (95%CI 60.7 to 71.3) the week following March 11th for those vaccinated with AstraZeneca (n = 87,632), compared with no rise for the unvaccinated comparison group (n = 175,264). Utilization of inpatient care also rose by 20% (95%CI -3.7 to 43.7) in week one and 61% (95%CI 27.1 to 94.9) in week two after March 11th. The sharpest increase in primary health care use was found for women aged 18-44 (83%, 95%CI 76.6 to 89.5) and for cleaners working in the health care sector (103 %, 95%CI 36.1 to 166.9). Conclusions: Health care use was highly affected by the media reports of a few fatal or severe side effects of the AstraZeneca vaccine. Our results suggest that the reports did not only lead vaccinated individuals to contact primary health care more, but also that physicians referred and treated more cases to specialist care because of the new information.

scholarly journals Chronic Comorbidities Contribute to the Burden and Costs of Persistent Asthma

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Paula Kauppi ◽  
Miika Linna ◽  
Juha Jantunen ◽  
Jaana E. Martikainen ◽  
Tari Haahtela ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Social Insurance ◽  
Age Groups ◽  
Persistent Asthma ◽  
Health Care Use ◽  
Psychiatric Disease ◽  
Care Services ◽  
Asthma Patients ◽  
Chronic Comorbidities

Background. We aimed to study the prevalence of chronic comorbidities in asthma patients and the costs of health care use associated with asthma with comorbidities.Material and Methods. We analysed the prevalence of the four most common chronic diseases in asthma patients in 2008–2014 in Finland. Prevalence of coronary artery disease, diabetes and dyslipidaemia, hypertension, epilepsy, inflammatory bowel disease, rheumatic diseases, and severe psychiatric disease was studied by register of the Social Insurance Institution of Finland. The costs of health care services were collected from the registries maintained by the National Institute for Health and Welfare (THL).Results. Prevalence of asthma was 4.6% in 2014. Diabetes was among the four most common comorbidities in all the age groups. The other common comorbidities were hypertension (≥46 years; 12.9–37.6%), severe psychiatric disorders (age groups of 16–59 years; 1.4–3.5%), and ischaemic heart disease (≥60 years; 10–25%). In patients with both asthma and diabetes, the costs of hospitalization were approximately 169% compared with patients with asthma alone.Conclusions. Prevalence of asthma increases by tenfold when aging. The comorbidity diversity and rate are age-dependent. Prevalence of diabetes as comorbidity in asthma has increased. Costs of hospitalizations in asthma approximately double with chronic comorbidities.

scholarly journals Structure and Distribution of Health Care Costs across Age Groups of Patients with Multimorbidity in Lithuania

2021 ◽  
Vol 18 (5) ◽  
pp. 2767
Author(s):  
Laura Nedzinskienė ◽  
Elena Jurevičienė ◽  
Žydrūnė Visockienė ◽  
Agnė Ulytė ◽  
Roma Puronaitė ◽  
...  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Chronic Disease ◽  
National Health Insurance ◽  
Health Care Services ◽  
Age Groups ◽  
Age Group ◽  
Resource Usage ◽  
Care Services ◽  
Care Costs

Background. Patients with multimorbidity account for ever-increasing healthcare resource usage and are often summarised as big spenders. Comprehensive analysis of health care resource usage in different age groups in patients with at least two non-communicable diseases is still scarce, limiting the quality of health care management decisions, which are often backed by limited, small-scale database analysis. The health care system in Lithuania is based on mandatory social health insurance and is covered by the National Health Insurance Fund. Based on a national Health Insurance database. The study aimed to explore the distribution, change, and interrelationships of health care costs across the age groups of patients with multimorbidity, suggesting different priorities at different age groups. Method. The study identified all adults with at least one chronic disease when any health care services were used over a three-year period between 2012 and 2014. Further data analysis excluded patients with single chronic conditions and further analysed patients with multimorbidity, accounting for increasing resource usage. The costs of primary, outpatient health care services; hospitalizations; reimbursed and paid out-of-pocket medications were analysed in eight age groups starting at 18 and up to 85 years and over. Results. The study identified a total of 428,430 adults in Lithuania with at least two different chronic diseases from the 32 chronic disease list. Out of the total expenditure within the group, 51.54% of the expenses were consumed for inpatient treatment, 30.90% for reimbursed medications. Across different age groups of patients with multimorbidity in Lithuania, 60% of the total cost is attributed to the age group of 65–84 years. The share in the total spending was the highest in the 75–84 years age group amounting to 29.53% of the overall expenditure, with an increase in hospitalization and a decrease in outpatient services. A decrease in health care expenses per capita in patients with multimorbidity after 85 years of age was observed. Conclusions. The highest proportion of health care expenses in patients with multimorbidity relates to hospitalization and reimbursed medications, increasing with age, but varies through different services. The study identifies the need to personalise the care of patients with multimorbidity in the primary-outpatient setting, aiming to reduce hospitalizations with proactive disease management.

scholarly journals The ecology of medical care in Norway: wide use of general practitioners may not necessarily keep patients out of hospitals

2012 ◽  
Vol 1 (2) ◽  
pp. 28 ◽  
Author(s):  
Anne Helen Hansen ◽  
Peder A. Halvorsen ◽  
Olav Helge Førde
Keyword(s):  
Health Care ◽  
General Practitioner ◽  
General Practitioners ◽  
Health Care Services ◽  
Medical Providers ◽  
Specialist Care ◽  
Cross Sectional ◽  
Care Services ◽  
And Gender ◽  
Complementary And Alternative

<em>Background</em>. Our aim was to investigate the pattern of self reported symptoms and utilisation of health care services in Norway. <em>Design and methods.</em> With data from the cross-sectional Tromsø Study (2007-8), we estimated population proportions reporting symptoms and use of seven different health services. By logistic regression we estimated differences according to age and gender. <em>Results</em>. 12,982 persons aged 30-87 years participated, 65.7% of those invited. More than 900/1000 reported symptoms or health problems in a year as well as in a month, and 214/1000 and 816/1000 visited a general practitioner once or more in a month and a year, respectively. The corresponding figures were 91/1000 and 421/1000 for specialist outpatient visits, and 14/1000 and 116/1000 for hospitalisations. Physiotherapists were visited by 210/1000, chiropractors by 76/1000, complementary and alternative medical providers by 127/1000, and dentists by 692/1000 in a year. Women used most health care services more than men, but genders used hospitalisations and chiropractors equally. Utilisation of all services increased with age, except chiropractors, dentists and complementary and alternative medical providers. <em>Conclusions</em>. Almost the entire population reported health related problems during the previous year, and most residents visited a general practitioner. Yet there were high rates of inpatient and outpatient specialist utilisation. We suggest that wide use of general practitioners may not necessarily keep patients out of specialist care and hospitals.

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