Objectives
This study quantifies change in healthcare utilisation and inpatient mortality of all adult patients hospitalised with Heart Failure in England during three coronavirus national lockdowns compared to the same time period in the previous year.
Methods
A retrospective cross-sectional study using the Hospital Episode Statistics (HES) database was conducted. All adults admitted to an English hospital with a primary diagnosis of I110 Hypertensive heart disease with (congestive) heart failure, I255 Ischaemic cardiomyopathy, I420 Dilated cardiomyopathy, I429 Cardiomyopathy unspecified, I500 Congestive heart failure, I501 Left ventricular failure and I509 Heart failure unspecified between 1st March 2019 and 28th February 2021 were included. Admissions, bed days and inpatient deaths of patients admitted between 1st March 2020 and 28th February 2021 (during pandemic) was compared with patients admitted between 1st March 2019 and 29th February 2020 (prior to pandemic). The difference in event count was used to test national changes and a P-value of ≤0.05 was used to test significance.
Results
There were 140,035 heart failure admissions in the observational period, 64,770 during the pandemic and 75,265 prior to the pandemic, all data were analysed. There were reductions in admissions (69,555 vs 80,715, P<0.0000000000), bed days (586,430 vs 753,985, P=0.0000000000) and inpatient deaths (7,650 vs 8,305, P=0.0000002154) during the pandemic.
Conclusions
There were significantly fewer admissions, bed days and inpatient deaths for patients admitted with heart failure during the coronavirus pandemic. Interpretation of this change is challenging as this may reflect unmet health needs as patients ‘put off’ seeking care. Further research is required to analyse the change in out of hospital healthcare utilisation, deaths in other settings and to explore potential for excess and latent morbidity and mortality that may result from reduced access to hospital services during the pandemic.
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