A systematic review published in BMJ Open on 17 March 2021, which summarised 81 studies from around the world that were conducted during the first four months of the Covid-19 pandemic, reveals the use of healthcare services such as visits to emergency departments, hospital visits, diagnostic tests and treatments dropped by 37% on average as a result of the pandemic.
The review found similar reductions across all forms of healthcare and that reductions in healthcare use were greater for those with milder conditions, such as for example visits to emergency departments for abdominal pain.
One study that was included in the review, from children’s emergency departments in Northern Italy, found “most of the non-relevant pathologies usually seen at our Eds have been avoided”, thus freeing resources to “provided critical services to patients suffering from medical emergencies in a timely manner”.
The systematic review was conducted by a global team from Canada, Sweden and Australia and was led from Bond University’s new Institute for Evidence-Based Healthcare, which is directed by Professor Paul Glasziou.
Professor Glasziou says that while “reductions in necessary care for cancer or cardiac disease are worrying and require action, any decrease in unnecessary care will reduce harm and waste and, may present an opportunity for system reform”.
The BMJ Open paper concludes that: “While addressing unmet need remains a priority, studies of health impacts of reductions may help health systems reduce unnecessary care in the post-pandemic recovery.”
Reportedly, the findings are similar to those published by the NSW Agency for Clinical Innovation in December, which also expressed concern about people missing needed care, but noted that falls in low-value care could be beneficial.
Using the example of a big drop in tonsillectomies, the report notes that: “In the case of low-value procedures, the Covid-19 pandemic presents an opportunity to revisit and potentially prevent the resumption of such activities.”
“Our review has important limitations outlined in our BMJ Open paper,” says lead author Dr Ray Moynihan, Assistant Professor at Bond’s Institute for Evidence-Based Healthcare, “and most notably it only covers the first four months of the pandemic.
“But there is a clear opportunity here to learn more about how to tackle unnecessary care, and free resources for unmet need.”
To read the study, visit: bmjopen.bmj.com/content/11/3/e045343
