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Indirect impact of Covid-19 on hospital care pathways in Italy.
Spadea, Teresa; Di Girolamo, Chiara; Landriscina, Tania; Leoni, Olivia; Forni, Silvia; Colais, Paola; Fanizza, Caterina; Allotta, Alessandra; Onorati, Roberta; Gnavi, Roberto.
  • Spadea T; Epidemiology Unit ASL TO3, Piedmont Region, Turin, Italy.
  • Di Girolamo C; Regional Health and Social Care Agency of Emilia-Romagna Region, Viale Aldo Moro, 21, 40128, Bologna, Italy. chiara.digirolamo@regione.emilia-romagna.it.
  • Landriscina T; Epidemiology Unit ASL TO3, Piedmont Region, Turin, Italy.
  • Leoni O; Regional Epidemiological Observatory, Lombardy Region, Milan, Italy.
  • Forni S; Regional Health Agency of Tuscany Region, Florence, Italy.
  • Colais P; Department of Epidemiology, Regional Health Service, Lazio Region, Rome, Italy.
  • Fanizza C; Regional Healthcare Agency of Puglia Region, Bari, Italy.
  • Allotta A; Department of Health Services and Epidemiological Observatory, Sicily Region, Palermo, Italy.
  • Onorati R; Epidemiology Unit ASL TO3, Piedmont Region, Turin, Italy.
  • Gnavi R; Epidemiology Unit ASL TO3, Piedmont Region, Turin, Italy.
Sci Rep ; 11(1): 21526, 2021 11 02.
Article in English | MEDLINE | ID: covidwho-1500514
ABSTRACT
Earlier in 2020, seven Italian regions, which cover 62% of the Italian population, set up the Mimico-19 network to monitor the side effects of the restrictive measures against Covid-19 on volumes and quality of care. To this aim, we retrospectively analysed hospital discharges data, computing twelve indicators of volume and performance in three clinical areas cardiology, oncology, and orthopaedics. Weekly indicators for the period January-July 2020 were compared with the corresponding average for 2018-2019; comparisons were performed within 3 sub-periods pre-lockdown, lockdown, and post-lockdown. The weekly trend of hospitalisations for ST-segment elevation myocardial infarction (STEMI) showed a 40% reduction, but the proportion of STEMI patients with a primary PTCA did not significantly change from previous years. Malignant neoplasms surgery volumes differed substantially by site, with a limited reduction for lung cancer (< 20%) and greater declines (30-40%) for breast and prostate cancers. The percentage of timely surgery for femoral neck in the elderly remained constantly higher than the previous 2 years whereas hip and knee replacements fell dramatically. Hospitalisations have generally decreased, but the capacity of a timely and effective response in time-dependent pathways of care was not jeopardized throughout the period. General trends did not show important differences across regions, regardless of the different burden of Covid-19. Preventive and primary care services should adopt a pro-active approach, moving towards the identification of at-risk conditions that were neglected during the pandemic and timely addressing patients to the secondary care system.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Hospitalization Type of study: Experimental Studies / Observational study / Prognostic study Limits: Female / Humans / Male Country/Region as subject: Europa Language: English Journal: Sci Rep Year: 2021 Document Type: Article Affiliation country: S41598-021-00982-4

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Hospitalization Type of study: Experimental Studies / Observational study / Prognostic study Limits: Female / Humans / Male Country/Region as subject: Europa Language: English Journal: Sci Rep Year: 2021 Document Type: Article Affiliation country: S41598-021-00982-4