LAUSR

Objectives: The COVID-19 pandemic impacted the German health system comprehensively. This study compared overall healthcare resource utilization (HCRU) in the first half of 2020 (COVID-19 lockdown time) with the utilization observed in previous years (2017-2019). Methods: The analysis was based on anonymized claims data of a German sickness fund (AOK PLUS), considering all individuals with at least one insurance day between 01/01/2017-30/06/2020. All hospitalizations, outpatient visits, and prescriptions were observed in the first half of each year. HCRU per 1,000 person-days (PTPD) observed in 2020 was compared with respective numbers of previous years. Results: We observed 3,322,504 insured persons (591,705,100 days) in the first half of 2020, with 0.68 hospitalizations PTPD (8.55% with at least one hospitalization). Hospitalization rates were considerably higher in the previous periods (2019/2018/2017: 0.79/0.80/0.82 inpatient stays PTPD;9.75%/9.95%/10.09% with at least one hospitalization). In the first half of 2020, 67.09% of the insured received at least one prescription of any medication with on average 1,936.87 DDDs PTPD. These numbers were very similar in the pre-years (2019/2018/2017: 68.94%/70.12%/69.93% and 1,925.79/1,949.66/1,982.60 DDDs PTPD). Proportion of patients with prescriptions for antiinfectives particularly decreased (-14.07%;ATC-code J-). Regarding outpatient treatment, with an unchanged overall number of outpatient visits, utilization of laboratory services increased substantially, followed by visits related to COVID-19. Cancer screening visits occurred far less frequently than in previous years (0.90 PTPD in 2020 versus 1.03/1.02/1.01 PTPD in 2019/2018/2017). Conclusions: In the first half of 2020, number of hospitalizations decreased substantially. This might be explained by lockdown measures themselves (postponement of planned inpatient treatments, general underuse of health care or reduction of the so far existent overuse) but might also be due to a lower number of non-COVID infections which as also prescriptions of antiinfectives decreased in this time.