Impact of COVID-19 on inpatient care related to skin conditions

Karolina Kalanj; Ante Orbanić; Mirta Peček; Stjepan Orešković; Rick Marshall; Mirna Šitum

doi:10.3389/fmed.2023.1123989

Impact of COVID-19 on inpatient care related to skin conditions

Front Med (Lausanne). 2023 Mar 2:10:1123989. doi: 10.3389/fmed.2023.1123989. eCollection 2023.

Authors

Karolina Kalanj^{1

2}, Ante Orbanić³, Mirta Peček⁴, Stjepan Orešković², Rick Marshall⁵, Mirna Šitum^{6

7}

Affiliations

¹ Department of Medical Oncology, Clinic of Oncology, Clinical Hospital Center, Zagreb, Croatia.
² Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia.
³ City Pharmacy Zagreb, Zagreb, Croatia.
⁴ School of Medicine, University of Zagreb, Zagreb, Croatia.
⁵ Epidemiologist and Independent Consultant in Health System Funding Models, Eaglehawk Neck, TAS, Australia.
⁶ University Hospital Centre Sestre Milosrdnice, Zagreb, Croatia.
⁷ School of Dental Medicine, University of Zagreb, Zagreb, Croatia.

Abstract

Background: The COVID-19 pandemic significantly affected our society and healthcare system. This study aims to evaluate the effects of COVID-19 on the number of hospitalized patients with dermatological diseases in Croatia, as well as the number of these patients treated surgically and conservatively, before (2017-2019) and during the pandemic (2020-2021).

Materials and methods: This is a retrospective, comparative study of the hospital admission rate for patients with skin, subcutaneous tissue, and breast disorders both before and during the pandemic. This study used data from the Croatian Institute of Public Health (CIPH) and the Croatian Health Insurance Fund (CHIF). Inpatient data for the CHIF data collection were categorized using the Australian Refined Diagnosis Related Groups (AR-DRGs). All hospital admissions for dermatology patients at all non-specialized hospitals in Croatia were tracked during two periods, before (2017-2019) and during the pandemic (2020-2021).

Results: The average number of dermatology patients in all hospitals fell by 29% during the pandemic. The overall number of dermatological patients admitted to hospitals fell by 32% in 2020 and by 26% in 2021 when compared to the number of patients admitted each year on average over the preceding 3 years. Additionally, there was an average 22% fall in surgical procedures performed during the pandemic. The only exception for surgical procedures is Major Breast Reconstruction for which is noted an increase, as also for Malignant Breast Disorders, Minor Complexity and Major Skin Disorders, Minor Complexity in a group of non-surgically treated patients.

Conclusion: Examining the all consequences of the Croatian dermatological patient care interruption will require more investigation. Reduced access to medical care during the pandemic is anticipated to lead to later illness diagnosis, a later start to treatment, a poorer disease prognosis, as well as higher medical expenditures.

Keywords: AR-DRG; COVID-19; data transparency; dermatology; health system response; inpatient care; pandemic; patient classification system.