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Changes in inpatient admissions before and during COVID-19 outbreak in a large tertiary hospital in Shanghai
Ya Yang1, Ke-Jia Le2, Chen Liang1
1Department of Medical Administration, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Insights
The COVID-19 outbreak significantly reduced hospital admissions by 26.35% and altered patient demographics. Key diagnoses like cancer treatments and stroke increased, impacting healthcare resource allocation during the pandemic.
Area of Science:
- Public Health
- Epidemiology
- Healthcare Management
Background:
- The COVID-19 pandemic placed unprecedented strain on global healthcare systems.
- Understanding the pandemic's specific impact on patient hospitalization patterns is crucial for resource management.
Purpose of the Study:
- To analyze the effect of the COVID-19 outbreak on inpatient hospital admission patterns.
- To provide data for informed healthcare resource allocation during pandemics.
Main Methods:
- Retrospective analysis of hospitalizations in a Shanghai tertiary teaching hospital from January to April 2017-2020.
- Comparison of patient volumes and International Classification of Diseases and Related Health Problem Tenth Edition (ICD-10) code frequencies before and during the COVID-19 outbreak.
- Statistical analysis of absolute and relative differences with 95% confidence intervals.
Main Results:
- Inpatient admissions decreased by 26.35% in Jan-Apr 2020 compared to 2019.
- The patient population in 2020 was older, with fewer self-paying and non-local patients.
- Admissions for cancer therapies (antineoplastic radiation, chemotherapy, immunotherapy), liver/bile duct malignancies, cerebral infarction, and chronic kidney disease increased in proportion.
Conclusions:
- The COVID-19 outbreak led to a significant decrease in overall inpatient numbers and a shift in admission diagnoses.
- Findings offer critical insights for hospital management and resource reallocation strategies during health crises.
Background:
The coronavirus disease 2019 (COVID-19) outbreak caused a significant strain on healthcare resources and utilization worldwide. However, the impact of COVID-19 outbreak on patient hospitalization was barely known. This study aimed to determine the impact of the outbreak on the pattern of inpatient hospital admissions to help allocate health care resources during a pandemic.
Methods:
This retrospective study included patients who were hospitalized in a tertiary teaching hospital in Shanghai between 1 January and 30 April across the years 2017 to 2020. The number of hospitalizations during the study period from 2017 to 2020 were 30,605, 31,464, 32,812 and 24,163, respectively. Changes in patient volumes and the frequency of the International Classification of Diseases and Related Health Problem Tenth Edition (ICD-10) codes before and after the onset of the COVID-19 outbreak were analyzed and presented as absolute and relative differences with 95% confidence intervals between periods of different years.
Results:
Overall inpatient hospital admissions decreased by 26.35% between January and April 2020, compared to the same period in 2019. The average age of patients in 2020 was higher compared to those from 2017 to 2019. Conversely, the proportions of self-paying patients and non-local patients were significantly lower between January and April 2020 compared to the same period in the previous three years. The top five ICD-10 codes remained common before and during the pandemic. Admissions associated with antineoplastic radiation therapy, chemotherapy, and immunotherapy increased in frequency and proportion by 2020 (difference, 5.6%, 95% CI: 4.4% to 6.8%), and increased proportions were observed for liver and intrahepatic bile duct malignancies (2.18%, 95% CI: 1.15% to 3.21%), cerebral infarction (2.27%, 95% CI: 0.54% to 4.00%), and chronic kidney disease (3.56%, 95% CI: 1.79% to 5.33%).
Conclusions:
There was a significant reduction in the number of inpatients and a marked change in admission diagnoses during the COVID-19 outbreak. Our findings are useful for making informed decisions on hospital management and reallocation of available health care resources during a pandemic.
