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During the various coronavirus pandemic waves in 2020, part of the regular medical care (non-COVID 19) was postponed. Partly as a result of postponed care, there were fewer hospital admissions in all age groups. At -6 percent, the decline was relatively lowest in neonatal and infant care (0-1 years); it was highest in the group aged 1 to 19 years at -22 percent. In older age groups, declines ranged between 11 and 13 percent.

Hospital admissions by age
2016 137.6 279.7 594.2 936.7 953.7 373.8
2017 126.3 269.1 569.1 891.8 941.2 367.0
2018 126.7 258.1 553.3 862.2 927.7 360.1
2019 128.9 257.1 555.3 861.9 946.1 364.8
2020* 121.8 199.3 496.2 747.9 845.7 325.5
* provisional figures

Declines seen in virtually all diagnostic categories

The decrease in hospital admissions occurred in virtually all diagnostic categories, but to a varying extent. On the whole, decreases were significant in categories with many admissions for plannable non-urgent care, but less significant in categories requiring severe and acute care.
The most prevalent type of admission was due to neoplasms as the main diagnosis, including malignant neoplasms (cancers): 554 thousand hospital admissions in 2020. This was 5 percent (31 thousand) lower than in 2019, representing a smaller decrease than the average across all admissions. There was hardly any decrease in outpatient treatment of malignant neoplasms; on the other hand, inpatient admissions (with at least one overnight stay) declined by 10 percent.
For digestive disorders, forming the second largest group with 347 thousand admissions, the decrease amounted to 12 percent. This is in line with the development of total hospital admissions. Within this group, the decrease was less significant in admissions for Crohn’s disease and ulcerative colitis (-4 percent), while admissions for appendicitis were up (+3 percent).

In 2020, admissions related to cardiovascular diseases were down by 8 percent on 2019. The decline was generally less significant in acute cardiovascular care. In acute cardiac care, for example, there were 4 percent fewer hospital admissions than in 2019, while hospital admissions for cerebrovascular accidents (CVA, strokes) declined by 1 percent. Compared to the average number of admissions over the period 2017-2019, these declines were even lower: -2 percent among cardiac patients and 0 percent among cerebrovascular patients.

Infectious diseases and plannable care declined more significantly

Among the main diagnostic categories, the sharpest declines in admissions were recorded in respiratory diseases excluding COVID-19 and in diseases of the ear: both 34 percent. There were fewer admissions for treatment of all underlying diagnoses, including respiratory infections such as pneumonia, but also for chronic lung diseases and for less severe disorders such as nose and throat tonsil infections.
Admissions declined sharply among other infectious diseases as well: -28 percent. A significant decrease was furthermore seen in admissions for ophthalmic (eye) diseases: -26 percent. For example, there was less cataract surgery on an outpatient basis (-32 percent). Relatively fewer admissions were seen for the treatment of skin diseases (-25 percent) and diseases of the musculoskeletal system (-22 percent), including a quarter fewer treatments of hip and knee osteoarthritis.

Hospital admissions by main diagnostic category
Neoplasms 544.1 575.5
Digestive disorders 347.3 393.3
CVD 334.1 364.3
Musculoskeletal disorders 184.5 235.6
Accidental injuries, poisoning 171.7 190.6
Pregnancy, delivery, maternity bed 161 170.4
Symptoms and unclear syndromes 148.5 178.8
Respiratory diseases 126.2 192.1
Genitourinary diseases 124.8 148.5
Other contacts with health services 122.7 144.5
Neonatal disorders 89 88.1
Diseases of the nervous system 64.6 79.7
Blood diseases 62.3 69.2
Eye diseases 56.5 76
Hormonal, nutritional and metabolic diseases 43.5 52.8
COVID-19 40.4 0
Ear disorders 30.5 46.5
Infectious and parasitic diseases 29.7 40.8
Skin diseases 24.6 32.6
Congenital defects 17.9 20
Mental disorders 12.8 14.8
* provisional figures

3 percent of inpatient admissions due to COVID-19

In 2020, COVID-19 was the main diagnosis in over 40 thousand admissions. This represented 3 percent of all inpatient admissions. The average hospital stay was substantially longer among the inpatient admissions for COVID-19: 8.4 days, compared to inpatient admissions not related to COVID-19 (5.2 days).
Altogether, nearly 34 thousand people were admitted to a hospital on single or multiple occasions with COVID-19 as the main diagnosis. Male patients (nearly 21 thousand) outnumbered female patients (13 thousand) in this category. Ninety-two percent of the COVID-19 patients were at least 45 years old; 59 percent were aged 65 or older.

COVID-19 patients, single and multiple admissions, 2020*
0-19 yrs 210 150
20-44 yrs 1195 1095
45-64 yrs 6895 4240
65-79 yrs 8370 4830
80 yrs and over 4040 2880
* provisional figures

Source of original article: Statistics Netherlands (CBS) (www.cbs.nl).
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