1. |
- Magnusson, Karin, et al.
(author)
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Healthcare use in 700 000 children and adolescents for six months after covid-19 : before and after register based cohort study
- 2022
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In: The BMJ. - : BMJ. - 0959-8146. ; 376
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Journal article (peer-reviewed)abstract
- Objectives To explore whether and for how long use of healthcare services is increased among children and adolescents after covid-19. Design Before and after register based study. Setting General population of Norway. Participants Norwegians aged 1-19 years (n=706 885) who were tested for SARS-CoV-2 from 1 August 2020 to 1 February 2021 (n=10 279 positive, n=275 859 negative) or not tested (n=420 747) and were not admitted to hospital, by age groups 1-5, 6-15, and 16-19 years. Main outcome measures Monthly percentages of all cause and cause specific healthcare use in primary care (general practitioner, emergency ward) and specialist care (outpatient, inpatient) from six months before to about six months after the week of being tested for SARS-CoV-2, using a difference-in-differences approach. Results A substantial short term relative increase in primary care use was observed for participants during the first month after a positive SARS-CoV-2 test result compared with those who tested negative (age 1-5 years: 339%, 95% confidence interval 308% to 369%; 6-15 years: 471%, 450% to 491%; 16-19 years: 401%, 380% to 422%). Use of primary care for the younger age groups was still increased at two months (1-5 years: 22%, 4% to 40%; 6-15 years: 14%, 2% to 26%) and three months (1-5 years: 26%, 7% to 46%, 6-15 years: 15%, 3% to 28%), but not for the oldest group (16-19 years: 11%, -2% to 24% and 6%, -7% to 19%, respectively). Children aged 1-5 years who tested positive also showed a minor long term (≤6 months) relative increase in primary care use (13%, -0% to 26%) that was not observed for the older age groups, compared with same aged children who tested negative. Results were similar yet the age differences less pronounced compared with untested controls. For all age groups, the increase in primary care visits was due to respiratory and general or unspecified conditions. No increased use of specialist care was observed. Conclusion Covid-19 among children and adolescents was found to have limited impact on healthcare services in Norway. Preschool aged children might take longer to recover (3-6 months) than primary or secondary school students (1-3 months), usually because of respiratory conditions.
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2. |
- Methi, Fredrik, et al.
(author)
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Pandemic trends in health care use : From the hospital bed to self-care with COVID-19
- 2022
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In: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 17:3 March
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Journal article (peer-reviewed)abstract
- Aim To explore whether the acute 30-day burden of COVID-19 on health care use has changed from February 2020 to February 2022. Methods In all Norwegians (N = 493 520) who tested positive for SARS-CoV-2 in four pandemic waves (February 26th, 2020 –February 16th, 2021 (1st wave dominated by the Wuhan strain), February 17th–July 10th, 2021 (2nd wave dominated by the Alpha variant), July 11th–December 27th, 2021 (3rd wave dominated by the Delta variant), and December 28th, 2021 – January 14th, 2022 (4th wave dominated by the Omicron variant)), we studied the age-@@@@@and sex-specific share of patients (by age groups 1–19, 20–67, and 68 or more) who had: 1) Relied on self-care, 2) used outpatient care (visiting general practitioners or emergency ward for COVID-19), and 3) used inpatient care (hospitalized ≥24 hours with COVID-19). Results We find a remarkable decline in the use of health care services among COVID-19 patients for all age/sex groups throughout the pandemic. From 83% [95%CI = 83%-84%] visiting outpatient care in the first wave, to 80% [81%-81%], 69% [69%-69%], and 59% [59%-59%] in the second, third, and fourth wave. Similarly, from 4.9% [95%CI = 4.7%-5.0%] visiting inpatient care in the first wave, to 3.6% [3.4%-3.7%], 1.4% [1.3%-1.4%], and 0.5% [0.4%-0.5%]. Of persons testing positive for SARS-CoV-2, 41% [41%-41%] relied on self-care in the 30 days after testing positive in the fourth wave, compared to 16% [15%-16%] in the first wave. Conclusion From 2020 to 2022, the use of COVID-19 related outpatient care services decreased with 29%, whereas the use of COVID-19 related inpatient care services decreased with 80%.
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3. |
- Skyrud, Katrine Damgaard, et al.
(author)
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Impacts of mild COVID-19 on elevated use of primary and specialist health care services : A nationwide register study from Norway
- 2021
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In: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 16:10 October
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Journal article (peer-reviewed)abstract
- Aim To explore the temporal impact of mild COVID-19 on need for primary and specialist health care services. Methods In all adults (≥20 years) tested for SARS-CoV-2 in Norway March 1st 2020 to February 1st 2021 (N = 1 401 922), we contrasted the monthly all-cause health care use before and up to 6 months after the test (% relative difference), for patients with a positive test for SARSCoV-2 (non-hospitalization, i.e. mild COVID-19) and patients with a negative test (no COVID-19). Results We found a substantial short-term elevation in primary care use in all age groups, with men generally having a higher relative increase (men 20–44 years: 522%, 95%CI = 509–535, 45–69 years: 439%, 95%CI = 426–452, ≥70 years: 199%, 95%CI = 180–218) than women (20–44 years: 342, 95%CI = 334–350, 45–69 years = 375, 95%CI = 365–385, ≥70 years: 156%, 95%CI = 141–171) at 1 month following positive test. At 2 months, this sex difference was less pronounced, with a (20–44 years: 21%, 95%CI = 13–29, 45–69 years = 38%, 95% CI = 30–46, ≥70 years: 15%, 95%CI = 3–28) increase in primary care use for men, and a (20–44 years: 30%, 95%CI = 24–36, 45–69 years = 57%, 95%CI = 50–64, ≥70 years: 14%, 95%CI = 4–24) increase for women. At 3 months after test, only women aged 45–70 years still had an increased primary care use (14%, 95%CI = 7–20). The increase was due to respiratory- and general/unspecified conditions. We observed no long-term (4–6 months) elevation in primary care use, and no elevation in specialist care use. Conclusion Mild COVID-19 gives an elevated need for primary care that vanishes 2–3 months after positive test. Middle-aged women had the most prolonged increased primary care use.
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4. |
- Skyrud, Katrine Damgaard, et al.
(author)
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Physiotherapy use is increased for up to nine months after receiving respiratory support for COVID-19
- 2022
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In: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 22:1
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Journal article (peer-reviewed)abstract
- Aim: To explore whether physiotherapy use is increased after hospitalization with COVID-19 with or without respiratory support vs. other respiratory tract infections (RTI). Methods: In all Norwegian residents aged 18–80 years who were hospitalized with COVID-19 (N = 5,344) or other RTI (N = 82,235) between July 1st 2017 and August 1st 2021, we used a pre-post study design to explore the weekly individual average physiotherapy use in community care from 12 weeks prior to hospital admission, to 36 weeks (9 months) after hospital discharge for individuals who received and who did not receive respiratory support. Results: Prior to the hospital stay, COVID-19 patients and patients with other RTI had ~ 40–60 physiotherapist consultations per 1000 inpatients per week. COVID-19 patients on respiratory support had a higher increase in physiotherapy use after discharge than persons with other RTI on respiratory support (an additional 27.3 (95% confidence interval = 10.2 to 44.4) consultations per 1000 for men, and 41.8 (13.7 to 69.9) per 1000 for women)). The increase in physiotherapy use lasted for 6 months for men, and 9 months for women. COVID-19 inpatients without respiratory support had a similar up-to-9-months-change post-discharge physiotherapy use as inpatients with other RTI without respiratory support (-0.2 (-0.7 to 0.2) for men, and 0.09 (-6.4 to 6.6) for women). Conclusion: The need for physiotherapy was increased for up to 9 months after having COVID-19 requiring respiratory support vs. other RTI requiring respiratory support. No difference between diseases was seen for individuals who were hospitalized but not on respiratory support.
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