Decrease in the number of cases due to Omicron: a reduction in excess and incorrect care is required
08.09.2022 10:24
During the Omicron wave, the number of cases in southwest German hospitals fell to a similar extent as in previous waves of infection. According to a current evaluation by the AOK Scientific Institute (WIdO), there was a total decrease of 17 percent in somatic hospital cases in Baden-Württemberg in the period from January to May 2022 compared to the comparable period in 2019.
“The decline in the number of cases in the latest wave of the pandemic is of a comparable magnitude to the waves before it, but for different reasons,” says Johannes Bauernfeind, CEO of AOK Baden-Württemberg, commenting on the results. “They are likely to be primarily due to staff shortages as a result of the numerous omicron infections, while at the beginning of the pandemic there were targeted cancellations of planned operations to maintain inpatient care.”
A look at the individual service areas from January to May 2022 again shows comparable declines in the number of cases in emergencies, cancer operations, planned operations and so-called outpatient-sensitive treatments as in the last three waves of the pandemic. In the Omicron wave, compared to the period from January to May 2019, there were 11 percent fewer heart attack treatments and 11 percent fewer stroke treatments in the hospitals in Baden-Württemberg. A similar picture emerges when it comes to cancer operations: breast cancer operations fell by minus 10 percent from January to May 2022, and colon cancer operations fell by minus 17 percent.
Plannable interventions, which had been significantly scaled back at the beginning of the pandemic in 2020 in order to relieve the burden on hospitals, have recently only seen moderate declines. The implantation of hip prostheses only fell by 4 percent. However, the decline in tonsil removals remains very high (minus 44 percent).
The sharp decline in so-called outpatient-sensitive diagnoses, which, according to experts, could very often be treated just as well in the outpatient setting, continued in the most recent wave of the pandemic in the southwest: minus 39 percent in the treatment of chronic obstructive pulmonary disease COPD, minus 40 percent for back pain, minus 41 percent for high blood pressure treatments and minus 24 percent for diabetes treatments. “We can no longer speak of a temporary pandemic effect here. These patients, who were treated in hospital more often in the past, no longer return there as quickly with these illnesses,” says Johannes Bauernfeind. This development must be taken into account when considering the reform of the hospital landscape in Germany. “The government commission is required to include in its considerations the reduction of excess and incorrect provision, which is at least partly hidden behind these figures.”
The WIdO analysis reveals some of the special features of the Omicron wave in Baden-Württemberg compared to the infection waves of 2020 and 2021: “With the Omicron wave, the proportion of patients who had to be hospitalized for Covid-19 fell. At the same time, the proportion of those for whom Covid-19 was not the primary reason for hospitalization increased,” explains Johannes Bauernfeind. “Therefore, in our current analyses, we only included those patients for whom, in addition to the Covid-19 diagnosis, another main diagnosis relevant to this disease, such as viral pneumonia or an acute respiratory infection, was coded.” The corresponding analysis shows that the proportion of hospitalized patients aged 18 and over who were dependent on ventilation has halved compared to the two previous waves of infection (from 23 to 12 percent). However, there was no positive development in the mortality of particularly seriously ill patients requiring ventilation: it remained at 50 percent even in the Omicron wave.