Evaluation of cardiovascular disease, diabetes, cancer and chronic obstructive pulmonary disease burden in Hacettepe University hospitals before and during COVID-19 pandemic (January 2018 – June 2021)

This study aimed to analyse admission status, fatality rates and relevant variations in time of patients who applied to Hacettepe University Hospitals at least once, between January 1, 2018 and June 15, 2021, with the diagnoses of cardiovascular disease (ischemic heart disease and hypertension) diabetes, cancer and chronic obstructive pulmonary disease, based on reported ICD-10 codes in electronic health records. Compared to the pre-COVID-19 period, the number of admissions for all 5 diseases decreased significantly during the pandemic. Number of total, outpatient- admission and inpatient-admissions significantly decreased (p<0.001) across time periods in analyses of dependent groups, controlling for seasonality and personal characteristics. The decrease in the admissions to general internal medicine, geriatrics, family practice and many departments was statistically significant for almost all diseases, except for the admissions to the emergency services and infectious diseases units. In time series analyses, admissions during the pandemic was below the estimated numbers, based on pre-pandemic admission numbers. A similar decrease was observed in expenditure data over the COVID-19 process, adjusting for inflation, based on the May 2021 consumer price index value. In Markov chain models established with disease-specific admission data and related expenditures, pre-pandemic and pandemic periods were compared, and significant differences in possibilities of admission numbers and/or expenditure combinations were further investigated. Study findings suggest that there has been a prominent disruption in non-communicable disease service provision and/or access to services during the pandemic period, and this may have negative impacts on admission rates, severity and fatality of these 5 diseases in upcoming periods. Hospital administrators, policy makers on non-communicable diseases, and public health professionals working on noncommunicable disease could use such evidence in guiding future interventions.