COVID-19: Study reveals impact of healthcare disruption on `avoidable hospitalisations’

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A new University of Liverpool-led study has found that people who found it difficult to access non-emergency healthcare during the COVID-19 pandemic were 80% more likely to be admitted to hospital for conditions that could have been potentially prevented through access to adequate care in their local area.

The study published in the British Medical Journal reveals that postponed or cancelled surgery, changes to treatments offered or delays in accessing cancer treatment were found to be particularly responsible for `avoidable hospitalisations’ as were disruption to accessing GP appointments and outpatients departments.

It found that 35% of people experienced some level of disruption in accessing healthcare during the pandemic. One in four (26%) had trouble accessing appointments with health officials, with almost one in five (18%) disrupted in receiving procedures.

The team from the University of Liverpool and the Universities of Glasgow, Bristol and the London School of Hygiene and Tropical Medicine analysed data from  nearly 30,000 from seven surveys which asked them about their experiences during the pandemic, linked to their medical records, over a two and half year period from the start of the COVID-19 pandemic.

University of Liverpool Reader in Health Geography, Dr Mark Green, who undertook the study, said: “The NHS was incredibly resilient during the pandemic and its staff were heroes in adapting to a stressful crisis. However, our study showed that the wider disruption created through the pandemic led to more people being hospitalised for reasons that could have been potentially prevented.

“Disruption was partly due to the NHS reorganising care to plan for surging numbers of people with COVID-19, including postponing care or moving appointments online. The public also avoided attending health care for worries about catching COVID-19 or wanting to avoid over-burdening the NHS during a crisis.”

“While the extent of this disruption was described at the time, our study is the first to empirically say what the impact of this disruption was.”

Professor Vittal Katikireddi, public health doctor at the University of Glasgow and co-author, said: “Our study suggested that the importance of maintaining continued care during the pandemic, particularly in delivering treatments and procedures.

“It is easier to move GP appointments online than compared to operations, surgeries or treatments that need to be delivered in person. Focusing on preventing disruption in delivering such care is a key takeaway in preparing for future pandemics.”

The study is part of the UKRI funded COVID-19 Longitudinal Health and Wellbeing National Core Study which was established by Sir Patrick Vallance, UK Chief Scientific Adviser, as part of the UK’s response to the COVID-19 pandemic.

The National Core study aims to understand the health, social and economic impacts of the COVID-19 pandemic by uniting established population cohorts and national anonymised electronic health records to inform policy.

The paper `Associations between self-reported healthcare disruption due to covid-19 and avoidable hospital admission: evidence from seven linked longitudinal studies for England’ (doi: 10.1136/bmj-2023-075133)  is published in the British Medical Journal