Hospital admissions and outpatient appointments dropped in 2020

Hospital corridor

Credit: VILevi/GettyImages

Research from the Institute for Fiscal Studies (IFS), Harvard University and Imperial College London shows that elective hospital admissions dropped by a third in 2020.

Outpatient appointments and non-COVID emergency admissions each fell by a fifth.

The data compared appointments between March and December 2020 and the same period in 2019.

The report was funded by the Economic and Social Research Council as part of UK Research and Innovation’s rapid response to COVID-19.

Who and where?

The researchers used new data from NHS England hospital records to examine patterns of hospital use during the first 10 months of the pandemic.

They looked for variations across:

  • geographic region
  • clinical speciality
  • age
  • sex
  • local area deprivation
  • ethnicity.

By showing who has been most affected by loss of care over the past year, the study will be vital for future planning of NHS resources.

The report’s main findings include:

  • the north and Midlands experienced bigger reductions in hospital activity than the south and east of England
  • paediatrics saw the largest reduction in emergency admission, with a 41% drop compared to the previous year
  • white individuals had a 37% reduction in elective admissions, compared with 36% for Asian individuals and 24% for black individuals
  • there were 1.9 million fewer physiotherapy outpatient appointments and 1.2 million fewer diagnostic imaging appointments.

Risk of exacerbating existing inequalities

Max Warner, an IFS research economist and an author of the report, said:

The COVID-19 pandemic forced the English NHS to reduce much of its normal hospital activity, while the number of emergency patients attending hospital has also fallen drastically.

This has affected millions of people, and will cost the government billions of pounds to catch up on missed treatment.

There are striking differences by ethnicity in the use of emergency care, with black and Asian individuals seeing much larger reductions than white individuals.

This risks exacerbating both health inequalities that existed before the pandemic and ethnic disparities in the impact of COVID-19.

Patient outcomes

Warner continued:

Ultimately what matters is how the loss of care has affected health and wellbeing.

Some of the missed care will have little consequence for future health but some of it will be very important.

It is therefore essential to learn more about how these changes in hospital use have affected patient outcomes during this period and which groups need particular support.

Last updated: 3 June 2021

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