Stuttgart – The number of somatic hospital cases in Baden-Württemberg fell by 14 percent in 2022 compared to 2019 – and thus even more than in 2020 and 2021 (minus 13 percent each). In psychiatric cases, the decline in 2022 was less pronounced than in 2019, at 8 percent. This is shown by an analysis by the Scientific Institute of the AOK (WIdO).
“Corona still had the clinics in the southwest firmly under control in the third year of the pandemic – but for different reasons than in the first waves of infection in 2020 and 2021,” says Dr. med Ralph Bier, physician at the AOK Baden-Württemberg. “The fall in the number of cases in the past year was no longer due to the capacity being kept free for seriously ill corona patients, but essentially to the enormous loss of staff as a result of the waves of infection in 2022 caused by the omicron variant.” In the comparison period of 2019, the first wave of infection was recorded from January to May 2022 (somatic cases down 17 percent, psychiatric cases down 10 percent).
Further sharp drops in outpatient-sensitive diagnoses
The breakdown of the figures according to the reasons for treatment in the inpatient area up to October 2022 shows: The sharpest declines in Baden-Württemberg were again in the so-called outpatient-sensitive diagnoses, which can be adequately treated both in the hospital and by appropriately qualified resident doctors. High blood pressure (minus 43 percent) and back pain (minus 37 percent) saw the largest declines compared to the year 2019, followed by the chronic lung disease COPD (minus 29 percent), diabetes (minus 25 percent) and heart failure (minus 15 percent). ). “Even in the first two years of the pandemic, there were declines of a comparable magnitude. Assuming that most of these patients have nevertheless sought medical help, Corona is apparently having an accelerating effect here in terms of the greater need for outpatient treatment, which is urgently needed in Baden-Württemberg. In the case of individual diagnoses, the reduction in oversupply is likely to play a role in view of the large and ongoing slumps,” says Dr. Beer.
In contrast to the two previous years, the number of operations in Germany for plannable hip joint implantations has normalized (1 percent) despite the omicron waves. On the other hand, there was another sharp drop in almond operations (minus 37 percent). “One reason could be that the hygiene rules during the pandemic have reduced the incidence of tonsillitis. But the declines could also indicate a reduction in oversupply,” says Bier. “Studies and analyzes show that these interventions were often carried out in the past without a guideline-based indication.”
Decrease in colorectal cancer surgeries even greater than in the two previous years
There was a 7 percent decrease in breast cancer surgeries in Baden-Württemberg compared to 2019. The development of bowel cancer surgeries is even more pronounced. These fell by 15 percent compared to the time before the pandemic – and thus even more than in the first (minus 9 percent) and second year of the pandemic (minus 14 percent). “This could have something to do with the reduced scope of the colonoscopies, which have already been shown in earlier evaluations of the WIdO,” explains Dr. Ralph Beer.
Also striking is the continuing decline in the number of cases of heart attacks and strokes, which can be seen in the WIdO data up to October 2022: Heart attack treatments in the south-west have fallen by 11 percent compared to 2019, stroke treatments by 7 percent. The declines in these emergencies were even greater than in the first and second years of the pandemic. “We can’t explain it 100 percent. The data suggest that the declines are larger for the milder heart attacks and strokes. Apparently, people with milder symptoms in particular were treated less in the hospital,” says Bier. The appeal to alert the emergency services in these emergencies without hesitation is still valid.
Proportion of severe Covid 19 diseases has fallen significantly
In its evaluation, the WIdO also considered the developments in inpatients who were hospitalized because of Covid-19. In the course of the omicron waves, the proportion of patients who were not primarily in the hospital because of Covid-19, but who nevertheless had this diagnosis, increased significantly in Baden-Württemberg in 2022. For a consistent comparison across the pandemic waves, the analysis was therefore limited to patients for whom Covid-19 was the primary reason for treatment. A comparison of the previous pandemic waves shows that the proportion of serious illnesses in the two omicron waves of 2022 has fallen significantly. The proportion of ventilated patients fell to 6 percent in the sixth wave of the pandemic from June to September 2022. For comparison: In the fourth wave at the end of 2021 it was still 23 percent.
Mortality in ventilated Covid 19 patients remains high
Mortality was also significantly lower in the southwest in the two omicron waves, at 17 and 12 percent, respectively, than in the fourth pandemic wave from October to December 2021 at 22 percent. In the third wave of the pandemic from March to May 2021, the mortality rate had already been 16 percent. In this phase of the pandemic, however, the low average age of the patients of 61 years is likely to have contributed to this. In the first two waves of the pandemic it was 68 and 69 years, respectively, in the omicron wave at the beginning of 2022 it was 72 years.
However, the mortality rate among ventilated patients in Baden-Württemberg remains high: it is 44 percent in the sixth wave of the pandemic. Of the ventilated patients, 57 percent are men. The continuously decreasing ventilation duration is striking. While this was still an average of 15 days in the first wave of the pandemic, it was only 8 days in the sixth wave of the pandemic in mid-2022. “The data reflect that the omicron variant of the virus fortunately leads to less severe disease progression than the predecessor variants of the coronavirus,” explains Dr. beer the results.
Notes for editors:
The evaluation of the WIdO on the number of hospital cases is based on the billing data of the AOK-insured persons, which represent about a third of the German population. The basis for the Covid-19 analyzes was the data from patients who were in the hospital because of Covid-19 – i.e. with a confirmed Covid-19 diagnosis and a main diagnosis relevant to this disease. The data of around 220,000 patients who were admitted to German hospitals from February 1, 2020 to September 30, 2022 were evaluated.
The AOK Baden-Württemberg insures over 4.5 million people in the state and has a budget of over 20 billion euros.
Information on the AOK Baden-Württemberg at www.aok.de/bw