Effect of COVID-19 on hospital visits in Ningbo, China: an interrupted time-series analysis

Abstract

Objective Unprecedented rigorous public health measures were implemented during the coronavirus disease 2019 (COVID-19) epidemic, but it is still unclear how the intervention influenced hospital visits for different types of diseases. We aimed to evaluate the impact of the intervention on hospital visits in Yinzhou District, Ningbo, Zhejiang province, China. Methods We conducted an interrupted time-series analysis from 1 January 2017 to 6 September 2020 based on the Yinzhou Health Information System in Ningbo, Zhejiang province. The beginning of the intervention was on 23 January 2020, and thus, there were 160 weeks before the intervention and 32 weeks after the implementation of the intervention. Level changes between expected and observed hospital visits in the post-intervention period were estimated using quasi-Poisson regression models. Results Compared with the expected level, there was an estimated decrease of −22.60% (95% confidence interval (CI): −27.53%, −17.36%) in the observed total hospital visits following the intervention. Observed hospital visits for diseases of the respiratory system were found to be decreased dramatically (−62.25%; 95% CI: −65.62%, −58.60%). However, observed hospital visits for certain diseases were estimated to be increased, including diseases of the nervous system (+11.17%; 95% CI: +3.21%, +19.74%); diseases of pregnancy, childbirth and the puerperium (+27.01%; 95% CI: +17.89%, +36.85%); certain conditions originating in the perinatal period (+45.05%; 95% CI: +30.24%, +61.56%); and congenital malformation deformations and chromosomal abnormalities (+35.50%; 95% CI: +21.24%, +51.45%). Conclusions Our findings provided scientific evidence that cause-specific hospital visits evolve differently following the intervention during the COVID-19 epidemic.

The impact of COVID-19 pandemic on hospital admissions for nine diseases in Iran: insight from an interrupted time series analysis

“…Our study indicates that hospital admissions fell dramatically with the onset of the COVID-19 pandemic for all of nine non-COVID-19 diseases investigated, including infectious and parasitic diseases, neoplasms, mental and behavioral disorders, diseases of the nervous system, diseases of the circulatory system, diseases of the respiratory system, diseases of the digestive system, diseases of the genitourinary system, and pregnancy, childbirth and the puerperium. Our results demonstrate a sharp and significant decrease in hospitalizations in the first month after the COVID-19 outbreak, which is consistent with previous studies in other countries [ 6 – 8 , 16 , 17 ]. A recent WHO survey looked at the extent of the disruption of services for the prevention and treatment of non-communicable diseases [ 23 ].…”

“…An interrupted time-series analysis in China indicated that observed total hospital visits and observed hospital visits for diseases of the respiratory system decreased by 22.60% and 62.25%, respectively, after the end of the COVID-19 lockdown in China [ 8 ]. A nationwide study in France found that the number of pediatric emergency department visits decreased by 68% after the outbreak of COVID-19 [ 7 ].…”

Impact of first UK COVID-19 lockdown on hospital admissions: Interrupted time series study of 32 million people

“…Substantial impact on secondary care due to COVID-19 pandemic have also been reported in other countries including Belgium, 21 South Africa, 22 China, 23 and South Korea. 24 Most of these studies looked at hospital admissions for any cause and undertook controlled ITS analysis comparing pre-pandemic and pandemic periods.…”

Long-Term Impact of COVID-19 on Hospital Visits of Rural Residents in Guangdong, China: A Controlled Interrupted Time Series Study

“…Dental, ophthalmology, and otolaryngology departments are high-risk departments for COVID-19 infection [ 65 , 66 , 67 ]. In the early stage of the COVID-19 pandemic, such departments in China were suspended or temporarily repurposed to treat patients with COVID-19 [ 68 ]. The restoration of such kinds of diseases can be explained by the restoration of cataract surgery during the COVID-19 pandemic.…”