Pandemic trends in health care use: From the hospital bed to self-care with COVID-19

by Fredrik Methi, Kjersti Helene Hernæs, Katrine Damgaard Skyrud, Karin Magnusson

Aim

To explore whether the acute 30-day burden of COVID-19 on health care use has changed from February 2020 to February 2022.

Methods

In all Norwegians (N = 493 520) who tested positive for SARS-CoV-2 in four pandemic waves (February 26^th, 2020 –February 16^th, 2021 (1^st wave dominated by the Wuhan strain), February 17^th–July 10^th, 2021 (2^nd wave dominated by the Alpha variant), July 11^th–December 27^th, 2021 (3^rd wave dominated by the Delta variant), and December 28^th, 2021 –January 14^th, 2022 (4^th wave dominated by the Omicron variant)), 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 outpatient care (visiting general practitioners or emergency ward for COVID-19), and 3) used inpatient care (hospitalized ≥24 hours with COVID-19).

Results

We find a remarkable decline in the use of health care services among COVID-19 patients for all age/sex groups throughout the pandemic. From 83% [95%CI = 83%-84%] visiting outpatient care in the first wave, to 80% [81%-81%], 69% [69%-69%], and 59% [59%-59%] in the second, third, and fourth wave. Similarly, from 4.9% [95%CI = 4.7%-5.0%] visiting inpatient care in the first wave, to 3.6% [3.4%-3.7%], 1.4% [1.3%-1.4%], and 0.5% [0.4%-0.5%]. Of persons testing positive for SARS-CoV-2, 41% [41%-41%] relied on self-care in the 30 days after testing positive in the fourth wave, compared to 16% [15%-16%] in the first wave.

Conclusion

From 2020 to 2022, the use of COVID-19 related outpatient care services decreased with 29%, whereas the use of COVID-19 related inpatient care services decreased with 80%.