COVID-19 Disruptions to Health Care Access Linked to Higher Risk of Hospitalization, Study Finds

COVID-19 Disruptions to Health Care Access Linked to Higher Risk of Hospitalization, Study Finds
Undated file photo of ambulances lined up outside the Medway Maritime Hospital in Gillingham, Kent, England. (Gareth Fuller/PA Media)
Lily Zhou
7/20/2023
Updated:
7/20/2023
0:00

Patients whose access to health care was disrupted during the COVID-19 pandemic are 80 percent more likely to be hospitalised, a study found.

According to the study, published in medical journal BMJ by researchers led by University of Liverpool lecturer Mark Green, more than a third of people (35 percent) in England were estimated to have experienced some disruptions to their access to health care, with disruption to an appointment being most common.

During the pandemic, the NHS delayed or cancelled appointments to cater for COVID-19 patients. Many patients also avoided hospitals either out of fear of contracting the disease caused by SARS-CoV-2 or in response to the government’s call to “protect the NHS.”

The study analysed NHS records of 29,276 people linked to seven longitudinal cohort studies for England who lived through March 1, 2020, and Aug. 25, 2022.

More than a quarter (26.2 percent) of the participants reported disruptions to appointments, nearly 1 in 5 (18.12 percent) had procedures disrupted, and about 1 in 17 (5.86 percent) had disrupted access to medicine, according to the paper.

“Overall, people who reported any form of disruption in accessing healthcare were more likely to have been admitted to hospital for an avoidable or potentially preventable condition” during the study period.

Researchers also noted that participants whose access to health care was disrupted tend to be older, sicker, and live in more deprived areas.

The study analysed data on unplanned avoidable hospital admissions using two commonly used measures for evaluating NHS performance—ambulatory care sensitive conditions and emergency urgent care sensitive conditions.

The former are conditions which can in theory be treated through community care and do not require hospital admission; the latter are acute exacerbations of urgent conditions that will potentially result in hospital admission, but that the NHS should be trying to treat within the community to minimise the need for hospital care.

The study found that patients with disrupted access to health care had an 80 percent higher chance of being hospitalised for ambulatory care sensitive conditions, and a 100 percent increase when it comes to acute conditions.

A breakdown of the figure shows an 80 percent increase in avoidable hospitalisation for chronic conditions and a twofold risk for acute conditions.

People who reported disruption in accessing procedures were also more likely to be admitted to hospital for emergency urgent care sensitive conditions, according to the study.

Procedure disruptions were associated with 77 percent higher odds of hospital admissions for any ambulatory care sensitive condition, compared with 52 percent higher chances associated with disrupted appointments.

People who had disrupted access to medicine were found to have 129 percent higher risk of hospital admissions for any ambulatory care sensitive condition, although researchers are less sure about this figure because the confidence interval is wide (true risk increase could be anywhere from 2 percent to 410 percent).

Mr. Green told The Telegraph that disrupted access to health care “might lead to a disproportionate decline in functioning where individuals could not access non-emergency treatment or if they were unable to see their GP, for example, to revise a treatment plan.”

“People might have been living in pain longer than they would have normally with delays to treatments, for example, if arthritis surgeries were postponed,” he added.

The NHS is still struggling to clear the backlog, and the situation has been compounded by rounds of strikes by nurses, doctors, and other health care professionals.

The number of patients waiting for hospital treatment in England each month between August 2007 and May 2023. (Data Source: <a href="https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/rtt-data-2023-24/">NHS</a>)
The number of patients waiting for hospital treatment in England each month between August 2007 and May 2023. (Data Source: NHS)

According to official data, 7.47 million people were waiting to start hospital treatment at the end of May, the highest number since records began in August 2007.