Retrospektive Analyse des Patientenaufkommens in der dermatologischen Hochschulambulanz während des ersten COVID-19-Lockdowns 2020
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Philipps-Universität Marburg
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The SARS-CoV-2 disease, discovered in late 2019, led to a need for political intervention due to its rapid spread. As of March 16, 2020, Germany was in an initial lockdown with restrictions on public life to contain the pandemic. The pandemic and pandemic-related measures impacted the German healthcare system. To prevent its overload, medically non-essential, scheduled hospital admissions, surgeries and medical interventions were postponed or suspended. The aim of the study was to investigate the changes in the patient volume within the dermatological university outpatient clinic of Marburg University Hospital during the first wave of the pandemic. All patients who presented themselves to the clinic between March 16 and April 4 in 2018, 2019, and 2020 or who failed to attend a previously scheduled appointment during the period, were evaluated in terms of their demographic data and diagnoses. Significantly more cancellations were recorded in the 2020 study period (34.06%) than in the previous two periods (5.72% in 2018, 5.34% in 2019). Most cancellations were made by the patients themselves. Nonetheless, the proportion of appointments that were missed, as well as cancellations by the university outpatient clinic, showed a significant increase in the 2020 period compared with the previous two periods. The number of cancellations increased with the onset of pandemic policies and decreased with initial easing of policies. No gender differences were found within patients who kept or cancelled their appointments. The average age of all patients included in the study also showed no significant difference. In the study period of 2020, a decrease in the number of patients of all age groups was evident, with the greatest decrease of 38.1% observed for the 81 ¬- 100 year old group. In the subgroup of patients with malignant neoplasms, there was a significantly lower average age in the study period of the year 2020 compared with the other two years. The average age was 63.4 in 2020, compared with 69.4 in 2018, and 73.0 in 2019. The analysis of diagnoses of presenting patients showed a decrease in the number of patients in six of eight diagnostic groups of diseases of the skin and subcutaneous tissue. The most significant decrease occurred in the bullous dermatoses group (L10-L12), with a decrease of 41.6% compared with 2018 and 33.3% compared with 2019, and in the papulosquamous diseases group (L40-L45), with a decrease of 31.35% compared with 2018 and 35.7% compared with 2019. Diagnoses of the skin and subcutaneous neoplasms groups (C00-D48) showed a significant decrease of 30% during the 2020 study period. Analysis of data on patients who cancelled or missed their appointment confirmed these results. The most common no-shows were in the papulosquamous diseases group and the skin and subcutaneous neoplasms group of patients. The vast majority of patients who did not keep their appointments were first-time presenters who were visiting the university outpatient clinic for the first time. Among the presenting patients, significantly fewer patients who presented themselves to the HSA for the first time due to their condition were recorded in the study period of 2020. The results confirm disparate impacts on specific patient groups. Individual diagnostic groups such as the skin and subcutaneous neoplasms group, autoimmune disease group and infectious diseases group were less likely to present during the initial pandemic lockdown. These results suggest that significantly fewer initial presentations and a decrease in the number of patients in individual diagnosis groups occurred. This was because, on the one hand, certain diagnoses were presented less frequently due to a decrease in screening and, on the other hand, many patients were unfamiliar with the facilities and wanted to avoid crowds. Conditions such as neoplasms require early diagnosis and treatment to improve the prognosis and course of the disease. The decrease in the number of infectious diseases can be assumed to be due to increased hygiene measures and contact restrictions. Decreases in the number of patients have also been reported in other areas of medicine both nationally and internationally. The study should help to identify the no-shows more specifically. In the future, further measures should be taken to specifically reach these patients during a pandemic or how their failure to present can be prevented. An important contribution to this can be made by the expansion of telemedicine and providing improved information to the population about existing medical care, despite the pandemic.
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Created: 2022Issued: 2023-07-06Updated: 2023-07-06
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Medizin
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Philipps-Universität Marburg
Language
ger
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DoctoralThesis
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610
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Federspiel, Pauline: Retrospektive Analyse des Patientenaufkommens in der dermatologischen Hochschulambulanz während des ersten COVID-19-Lockdowns 2020. : Philipps-Universität Marburg 2023-07-06. DOI: https://doi.org/10.17192/z2023.0377.