Estimating the health impact of delayed elective care during the COVID -19 pandemic in the Netherlands

Marije Oosterhoff; Lisanne Kouwenberg; Adriënne Rotteveel; Ella van Vliet; Niek Stadhouders; Ardine de Wit; Anoukh van Giessen

doi:10.1016/j.socscimed.2023.115658

Estimating the health impact of delayed elective care during the COVID -19 pandemic in the Netherlands

Marije Oosterhoff
, Lisanne Kouwenberg
, Adriënne Rotteveel
, Ella van Vliet
, Niek Stadhouders
, Ardine de Wit
, Anoukh van Giessen

Research output: Contribution to Journal › Article › Academic › peer-review

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Abstract

Background
The COVID-19 pandemic had a major impact on the continuity of healthcare provision. Appointments, treatments and surgeries for non-COVID patients were often delayed, with associated health losses for patients involved.
Objective

To develop a method to quantify the health impact of delayed elective care for non-COVID patients.

Methods
A model was developed that estimated the backlog of surgical procedures in 2020 and 2021 using hospital registry data. Quality-adjusted life years (QALYs) were obtained from the literature to estimate the non-generated QALYs related to the backlog. In sensitivity analyses QALY values were varied by type of patient prioritization. Scenario analyses for future increased surgical capacity were performed.

Results
In 2020 and 2021 an estimated total of 305,374 elective surgeries were delayed. These delays corresponded with 319,483 non-generated QALYs. In sensitivity analyses where QALYs varied by type of patient prioritization, non-generated QALYs amounted to 150,973 and 488,195 QALYs respectively. In scenario analyses for future increased surgical capacity in 2022–2026, the non-generated QALYs decreased to 311,220 (2% future capacity increase per year) and 300,710 (5% future capacity increase per year). Large differences exist in the extent to which different treatments contributed to the total health losses.

Conclusions
The method sheds light on the indirect harm related to the COVID-19 pandemic. The results can be used for policy evaluations of COVID-19 responses, in preparations for future waves or other pandemics and in prioritizing the allocation of resources for capacity increases.

Original language	English
Article number	115658
Pages (from-to)	1-11
Number of pages	11
Journal	Social Science & Medicine
Volume	320
Early online date	4 Jan 2023
DOIs	https://doi.org/10.1016/j.socscimed.2023.115658
Publication status	Published - Mar 2023

Funding

We thank Geert Jan Kommer and Peter Paul Klein for their helpful advice and suggestions. The authors (MO, LK, AR, EV, NS, AW and AG) are current or former employees of the National Institute of Public Health and the Environment (RIVM). RIVM received a grant from the Dutch Ministry of Health, Welfare and Sports for the COVID-19 research program, with which this study was funded. The funder had no role in the study design, data collection, analysis and writing of the manuscript. We thank Geert Jan Kommer and Peter Paul Klein for their helpful advice and suggestions. The authors (MO, LK, AR, EV, NS, AW and AG) are current or former employees of the National Institute of Public Health and the Environment (RIVM) . RIVM received a grant from the Dutch Ministry of Health, Welfare and Sports for the COVID-19 research program, with which this study was funded. The funder had no role in the study design, data collection, analysis and writing of the manuscript.

Funders
National Institute of Public Health and the Environment
Ministerie van Volksgezondheid, Welzijn en Sport
Rijksinstituut voor Volksgezondheid en Milieu

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Estimating the health impact of delayed elective care during the COVID -19 pandemic in the NetherlandsFinal published version, 3.12 MBLicence: Article 25fa Dutch Copyright Act

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title = "Estimating the health impact of delayed elective care during the COVID -19 pandemic in the Netherlands",

abstract = "Background The COVID-19 pandemic had a major impact on the continuity of healthcare provision. Appointments, treatments and surgeries for non-COVID patients were often delayed, with associated health losses for patients involved. Objective To develop a method to quantify the health impact of delayed elective care for non-COVID patients. Methods A model was developed that estimated the backlog of surgical procedures in 2020 and 2021 using hospital registry data. Quality-adjusted life years (QALYs) were obtained from the literature to estimate the non-generated QALYs related to the backlog. In sensitivity analyses QALY values were varied by type of patient prioritization. Scenario analyses for future increased surgical capacity were performed. Results In 2020 and 2021 an estimated total of 305,374 elective surgeries were delayed. These delays corresponded with 319,483 non-generated QALYs. In sensitivity analyses where QALYs varied by type of patient prioritization, non-generated QALYs amounted to 150,973 and 488,195 QALYs respectively. In scenario analyses for future increased surgical capacity in 2022–2026, the non-generated QALYs decreased to 311,220 (2\% future capacity increase per year) and 300,710 (5\% future capacity increase per year). Large differences exist in the extent to which different treatments contributed to the total health losses. Conclusions The method sheds light on the indirect harm related to the COVID-19 pandemic. The results can be used for policy evaluations of COVID-19 responses, in preparations for future waves or other pandemics and in prioritizing the allocation of resources for capacity increases.",

author = "Marije Oosterhoff and Lisanne Kouwenberg and Adri{\"e}nne Rotteveel and Vliet, \{Ella van\} and Niek Stadhouders and Wit, \{Ardine de\} and Giessen, \{Anoukh van\}",

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AU - Stadhouders, Niek

AU - Wit, Ardine de

AU - Giessen, Anoukh van

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N2 - Background The COVID-19 pandemic had a major impact on the continuity of healthcare provision. Appointments, treatments and surgeries for non-COVID patients were often delayed, with associated health losses for patients involved. Objective To develop a method to quantify the health impact of delayed elective care for non-COVID patients. Methods A model was developed that estimated the backlog of surgical procedures in 2020 and 2021 using hospital registry data. Quality-adjusted life years (QALYs) were obtained from the literature to estimate the non-generated QALYs related to the backlog. In sensitivity analyses QALY values were varied by type of patient prioritization. Scenario analyses for future increased surgical capacity were performed. Results In 2020 and 2021 an estimated total of 305,374 elective surgeries were delayed. These delays corresponded with 319,483 non-generated QALYs. In sensitivity analyses where QALYs varied by type of patient prioritization, non-generated QALYs amounted to 150,973 and 488,195 QALYs respectively. In scenario analyses for future increased surgical capacity in 2022–2026, the non-generated QALYs decreased to 311,220 (2% future capacity increase per year) and 300,710 (5% future capacity increase per year). Large differences exist in the extent to which different treatments contributed to the total health losses. Conclusions The method sheds light on the indirect harm related to the COVID-19 pandemic. The results can be used for policy evaluations of COVID-19 responses, in preparations for future waves or other pandemics and in prioritizing the allocation of resources for capacity increases.

AB - Background The COVID-19 pandemic had a major impact on the continuity of healthcare provision. Appointments, treatments and surgeries for non-COVID patients were often delayed, with associated health losses for patients involved. Objective To develop a method to quantify the health impact of delayed elective care for non-COVID patients. Methods A model was developed that estimated the backlog of surgical procedures in 2020 and 2021 using hospital registry data. Quality-adjusted life years (QALYs) were obtained from the literature to estimate the non-generated QALYs related to the backlog. In sensitivity analyses QALY values were varied by type of patient prioritization. Scenario analyses for future increased surgical capacity were performed. Results In 2020 and 2021 an estimated total of 305,374 elective surgeries were delayed. These delays corresponded with 319,483 non-generated QALYs. In sensitivity analyses where QALYs varied by type of patient prioritization, non-generated QALYs amounted to 150,973 and 488,195 QALYs respectively. In scenario analyses for future increased surgical capacity in 2022–2026, the non-generated QALYs decreased to 311,220 (2% future capacity increase per year) and 300,710 (5% future capacity increase per year). Large differences exist in the extent to which different treatments contributed to the total health losses. Conclusions The method sheds light on the indirect harm related to the COVID-19 pandemic. The results can be used for policy evaluations of COVID-19 responses, in preparations for future waves or other pandemics and in prioritizing the allocation of resources for capacity increases.

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Estimating the health impact of delayed elective care during the COVID -19 pandemic in the Netherlands

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