Analysis with MHB participation: Health system proved effective in COVID-19 pandemic

Neuruppin, 19 March 2024

The German system of health care has proved effective in the COVID 19 pandemic, so the results of a new data analysis headlined “Short Term Outcomes and Treatment Intensity of Major Cardiovascular Emergencies During the SARS-CoV2 Pandemic in Germany“. The Brandenburg Medical School Theodor Fontane (MHB) participated in the study.

Many medical areas saw a decline in hospital treatment during the COVID-19 pandemic. The study used routine records provided by health insurer BARMER to compare the treatment of cardiovascular emergencies in Germany during the pandemic with the previous two years. Researchers analyzed 140.989 hospital treatments of 122.340 patients (48,3 % females) in the period of 2018-2021. These patients were hospitalized for emergency treatment of acute coronary syndrome or myocardial infarction (46 %), acute stroke (45 %) and acute limb ischemia (9 %).

Various aspects of care provision and pertinent characteristics were explored over the course of the pandemic. The current study also searched for gender-specific differences in emergency care. One notable observation was that women were about five years older on average than male patients at hospital admission. Further differences between genders were found for comorbidities, i.e. secondary diseases, and care levels. All analyses were therefore run separately for males and females. Propensity Score Matching, a statistical method to evaluate observation data, was used to compare the years 2020/2021 and 2018/2019 and thus to assess the impact of the pandemic on care provision. The method did not reveal any significant differences for secondary illnesses. The implication is that patients’ general conditions did not undergo any significant changes during the pandemic compared to the years before.

                                                                                                  ^{Dr. Christian-Alexander Behrendt}

Another observation was that during the pandemic, patients with acute stroke tended to have a higher care level. Moreover, patients were discharged from hospital more quickly, and the percentage of invasive interventions increased. No significant differences, however, were found for mortality during the pandemic compared to the time before. No statistically notable changes were found for hospital mortality nor for 30-day total mortality.  

“The COVID-19 pandemic was a great challenge for the German health system. The system worked effectively despite the considerable burdens, specifically in the treatment of cardiovascular emergencies. Positive factors are the decentralized organization and the wide network of hospitals and clinics with or without university association. Care provision by non-university hospitals plays an important role in cardiovascular emergencies. This decentralized structure has turned out to be an advantage since it has permitted comprehensive and flexible provision. Fears that the pandemic might lead to poorer care supply for heart attacks, strokes and acute limb ischemia have thankfully not been justified. There were no indications of relevant collateral damage in the in-patient treatment of these emergencies,” says Dr. Christian-Alexander Behrendt (medical-scientific director of DIGG, the German institute for vascular health research) on behalf of the MHB research team German Vasc.

Results from the analysis give insights into the impact of the pandemic on patient care and reveal changes in certain treatment practices as well as continuity in other respects. The study also documents that hospital treatment of cardiovascular emergencies during the COVID-19 pandemic did not result in higher mortality rates. Hospital practices were adapted successfully, and study results underline the resilience of the German health system amid a massive pandemic. Summing up, Dr. Behrendt says it is encouraging to see that our health system is robust and resistant even to extreme stress, “thanks to the efforts of all actors involved in healthcare, including physicians, medical staff, health insurers and policy makers.”

The article is online at: www.sciencedirect.com/science/article/pii/S1078588424002533

Scientific contact
Dr. Christian-Alexander Behrendt
behrendt@hamburg.de