Estimating the health impact of delayed elective care during the COVID -19 pandemic in the Netherlands

Oosterhoff, Marije; Kouwenberg, Lisanne H. J. A.; Rotteveel, Adriënne H.; Vliet, Ella D. van; Stadhouders, Niek; Wit, G. Ardine de; Giessen, Anoukh van

doi:10.1016/j.socscimed.2023.115658

Cited by 10 publications

(4 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Short staffed, hospitals were forced to focus on COVID care at the exclusion of other services while small private clinics, unable to adequately manage infection risks, remained shuttered. The pandemic's long-term impact on public health caused by postponing elective surgeries, checkups, and priority medical procedures (such as cancer therapy) 11,12 is not known.…”

Section: The Covid-19 Pandemic and Beyond Epidemiologymentioning

confidence: 99%

The Emerging Role of Photobiomodulation in COVID-19 Therapy – Part I

Williams

2023

MRAJ

View full text Add to dashboard Cite

Background. Infectivity, genomic variability, and symptomatic diversity of the SARS-CoV-2 virus represents a persistent challenge in the treatment of acute and long COVID-19 diseases. A direct consequence of pervasive ACE-2 receptors susceptible to the virion’s spike protein, disease trajectories commence as upper respiratory infection migrating into bronchia (presenting coughing, dyspnea, and fever), followed by viremic infection and circulatory distress from inflammation of visceral epithelium and vascular endothelia, decreased blood perfusion, and hypoxia. Severe cases include hyperinflammation, cytokine storms, and multisystem inflammatory syndrome with lung and nerve damage, and chronic cognitive deficits. Method. This paper (Part I) considers the requirements for treating acute and chronic COVID-19 with deep-tissue photobiomodulation (PBM) of sinuses, lungs and other ACE-2 populated organs using transdermal and transcranial light as a primary therapeutic modality. Analysis. A detailed analysis of optics, biophysics, numerical simulations, and quantum photochemistry for non-invasive deep tissue PBM of SARS-CoV-2 infected organs was performed including optical design, photonic control, irradiance, fluence, modulation, and protocols. Results. Analysis concludes large-area 3D bendable LED pads are best suited for deep-tissue PBM to transdermally treat whole-organ infection of the lungs, sinuses, abdominal cavity (and to transcranially treat long-COVID). Robotic laser scanning represents another viable option for deep-tissue PBM provided the optical angle of incidence is minimal. Penetration depth depends on wavelength (not optical power) with red (635nm) and NIR (850nm) shown to adequately penetrate through cutaneious tissue and parietal fascia into viscera. Conclusions. Red and NIR LEDs with average pulsed irradiances of 8.5 and 13.5 mW/cm2 respectively deliver hands-free whole-organ deep-tissue doses of between 0.5 to 4.0 J/cm2 in 60 min sessions from a surface dose of Pl/A = 40 J/cm2 depending on tissue transmission coefficients Yx at depth x>6mm. The designed photonic PBM system performs algorithmic variable frequency pulsed protocols covering up to 1,200 cm2. Duty factor control limits skin temperatures below 43°C irrespective of pulse modulating frequency. A mechanistic model for deep-tissue PBM, phenomenologically consistent with biophysics, photon penetration studies, COVID disease trajectories, and patient recovery profiles is presented. Part II details various acute and chronic case studies and positive outcomes thereof confirming PBM as a efficacious modality for COVID-19.

show abstract

Section: The Covid-19 Pandemic and Beyond Epidemiologymentioning

confidence: 99%

The Emerging Role of Photobiomodulation in COVID-19 Therapy – Part I

Williams

2023

MRAJ

View full text Add to dashboard Cite

show abstract

“…In the Netherlands, during 2020 the total volume of hospital admissions decreased with 12% compared with 2019 [13]. Consequently, an estimated 320 thousand quality adjusted life years were lost due to postponed or forgone elective surgery in the Netherlands in 2020 and 2021 [9,14,15]. Disrupted hospital use in this study refers to hospital care that is either postponed or cancelled by the healthcare provider, or postponed or foregone by the patient.…”

Section: Introductionmentioning

confidence: 99%

Disruption of hospital care during the first year of the COVID-19 pandemic impacted socioeconomic groups differently: population based study using routine registration data

Jansen,

Gouwens,

Meijerink

et al. 2024

BMC Health Serv Res

Self Cite

View full text Add to dashboard Cite

Background During the COVID-19 pandemic, provision of non-COVID healthcare was recurrently severely disrupted. The objective was to determine whether disruption of non-COVID hospital use, either due to cancelled, postponed, or forgone care, during the first pandemic year of COVID-19 impacted socioeconomic groups differently compared with pre-pandemic use. Methods National population registry data, individually linked with data of non-COVID hospital use in the Netherlands (2017–2020). in non-institutionalised population of 25–79 years, in standardised household income deciles (1 = low, 10 = high) as proxy for socioeconomic status. Generic outcome measures included patients who received hospital care (dichotomous): outpatient contact, day treatment, inpatient clinic, and surgery. Specific procedures were included as examples of frequently performed elective and acute procedures, e.g.: elective knee/hip replacement and cataract surgery, and acute percutaneous coronary interventions (PCI). Relative risks (RR) for hospital use were reported as outcomes from generalised linear regression models (binomial) with log-link. An interaction term was included to assess whether income differences in hospital use during the pandemic deviated from pre-pandemic use. Results Hospital use rates declined in 2020 across all income groups. With baseline (2019) higher hospital use rates among lower than higher income groups, relatively stronger declines were found for lower income groups. The lowest income groups experienced a 10% larger decline in surgery received than the highest income group (RR 0.90, 95% CI 0.87 – 0.93). Patterns were similar for inpatient clinic, elective knee/hip replacement and cataract surgery. We found small or no significant income differences for outpatient clinic, day treatment, and acute PCI. Conclusions Disruption of non-COVID hospital use in 2020 was substantial across all income groups during the acute phases of the pandemic, but relatively stronger for lower income groups than could be expected compared with pre-pandemic hospital use. Although the pandemic’s impact on the health system was unprecedented, healthcare service shortages are here to stay. It is therefore pivotal to realise that lower income groups may be at risk for underuse in times of scarcity.

show abstract

“…Although healthcare procedures decreased during the pandemic, it is unclear whether this reduction was evenly distributed among all individuals or if specific population groups, such as marginalised communities, were disproportionately affected. Insights into how the decline of non-COVID healthcare differed between demographic groups remain an important line of inquiry that can inform policy efforts to mitigate the long-term effects of missed or delayed healthcare (Dinmohamed et al 2020;Mehrotra et al 2021;Oosterhoff et al 2023;Padmaja and Behera 2023;Riera et al 2020).…”

Section: Main Text: Introductionmentioning

confidence: 99%

Inequalities in Healthcare Use during the COVID-19 Pandemic

Frey

Tilstra

Verhagen

2023

Preprint

View full text Add to dashboard Cite

The COVID-19 pandemic has led to severe reductions in non-COVID related healthcare use, but little is known whether this burden is shared equally across the population. This study investigates whether the reduction in administered care disproportionately affected certain sociodemographic strata, in particular marginalised groups. Using detailed medical claims data from the Dutch universal health care system and rich registry data that cover all residents in The Netherlands, we predict expected healthcare use based on pre-pandemic trends (2017– Feb 2020) and compare these expectations with observed healthcare use in 2020. Our findings reveal a substantial 10% decline in the number of weekly treated patients in 2020 relative to prior years. Furthermore, declines in healthcare use are unequally distributed and are more pronounced for individuals below the poverty line, females, the elderly, and foreign-born individuals, with cumulative relative risk ratios ranging from 1.09 to 1.22 higher than individuals above the poverty line, males, young, and native-born. These inequalities stem predominantly from declines in middle and low urgency procedures, and indicate that the pandemic has not only had an unequal toll in terms of the direct health burden of the pandemic, but has also had a differential impact on the use of non-COVID healthcare.

show abstract

Estimating the health impact of delayed elective care during the COVID -19 pandemic in the Netherlands

Cited by 10 publications

References 41 publications

The Emerging Role of Photobiomodulation in COVID-19 Therapy – Part I

The Emerging Role of Photobiomodulation in COVID-19 Therapy – Part I

Disruption of hospital care during the first year of the COVID-19 pandemic impacted socioeconomic groups differently: population based study using routine registration data

Inequalities in Healthcare Use during the COVID-19 Pandemic

Contact Info

Product

Resources

About