Indirect impact of Covid-19 on hospital care pathways in Italy

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, computi...

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Autores principales:	Teresa Spadea, Chiara Di Girolamo, Tania Landriscina, Olivia Leoni, Silvia Forni, Paola Colais, Caterina Fanizza, Alessandra Allotta, Roberta Onorati, Roberto Gnavi, the Mimico-19 working group
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/359e48e6624e42a28c04a74bd11d54c0
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spelling	oai:doaj.org-article:359e48e6624e42a28c04a74bd11d54c02021-11-08T10:53:46ZIndirect impact of Covid-19 on hospital care pathways in Italy10.1038/s41598-021-00982-42045-2322https://doaj.org/article/359e48e6624e42a28c04a74bd11d54c02021-11-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-00982-4https://doaj.org/toc/2045-2322Abstract 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.Teresa SpadeaChiara Di GirolamoTania LandriscinaOlivia LeoniSilvia ForniPaola ColaisCaterina FanizzaAlessandra AllottaRoberta OnoratiRoberto Gnavithe Mimico-19 working groupNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Teresa Spadea Chiara Di Girolamo Tania Landriscina Olivia Leoni Silvia Forni Paola Colais Caterina Fanizza Alessandra Allotta Roberta Onorati Roberto Gnavi the Mimico-19 working group Indirect impact of Covid-19 on hospital care pathways in Italy
description	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.
format	article
author	Teresa Spadea Chiara Di Girolamo Tania Landriscina Olivia Leoni Silvia Forni Paola Colais Caterina Fanizza Alessandra Allotta Roberta Onorati Roberto Gnavi the Mimico-19 working group
author_facet	Teresa Spadea Chiara Di Girolamo Tania Landriscina Olivia Leoni Silvia Forni Paola Colais Caterina Fanizza Alessandra Allotta Roberta Onorati Roberto Gnavi the Mimico-19 working group
author_sort	Teresa Spadea
title	Indirect impact of Covid-19 on hospital care pathways in Italy
title_short	Indirect impact of Covid-19 on hospital care pathways in Italy
title_full	Indirect impact of Covid-19 on hospital care pathways in Italy
title_fullStr	Indirect impact of Covid-19 on hospital care pathways in Italy
title_full_unstemmed	Indirect impact of Covid-19 on hospital care pathways in Italy
title_sort	indirect impact of covid-19 on hospital care pathways in italy
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/359e48e6624e42a28c04a74bd11d54c0
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Indirect impact of Covid-19 on hospital care pathways in Italy

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