It was known that a lot of care has been postponed due to the corona crisis. But it is not yet clear what the consequences will be. The Cooperating Quality Registrations have taken a first step towards clarifying this. The main conclusion is that in 2020 fewer people will be treated for serious diseases such as cancer and emergency heart disease, especially in the first wave. For some people, the delayed care now comes too late, for example with advanced cancer or a stroke that was treated too late. Others have a lot of pain or discomfort from the delayed care.
Six different registrations of specialist medical care put the data together. The collected figures concern: acute care, oncological care, orthopedic care, heart care, elective care (ie the placement of a new knee) and chronic care. Not surprisingly, fewer patients were helped in all of these areas in 2020 than in previous years.
Acute care also postponed
Care has also been postponed in the field of acute care, despite attempts to continue to help people with emergency care during the corona outbreak. After all, with a heart attack or stroke, you don’t have a minute to lose. That did not always work out, especially during the first wave. This has undoubtedly led to damage, according to Bas van Bussel, board member of National Intensive Care Evaluation and intensivist. “In many acute conditions, such as brain and heart attacks, this has almost certainly led to permanent health damage because treatments cannot be postponed.”
In the second wave, doctors urged people to come to the hospital quickly with this kind of emergency. That helped, and more people have been treated.
Less cancer treatment
In the field of cancer, 11 percent fewer operations were performed in the first corona wave, according to figures for 13 tumor types. Here too, patients in the second wave visited the hospital more often. In the treatment of cancer, treatments were also pushed back. For example, surgery for lung cancer was replaced by radiation because of the risks, so that the overloaded ICs did not have to be used. The most notable drop in both corona waves was elective care. Knee and hip replacements have been massively postponed. This causes a lot of pain and complaints in people who are waiting for such an operation.
Quality
The people behind these registrations concluded that the quality of the care provided was not compromised, because there was no increase in complications or death from complications. That may be true for the treatments themselves, but those numbers don’t say everything about how people are doing. Delayed heart operations can lead to permanent damage to health and to earlier death, the specialists of the registers acknowledge. The same applies to people with kidney damage for whom treatment has been postponed, for example the placement of a donor kidney. Or in people who are now being treated at a later stage with melanoma (skin cancer) or lung cancer. The victims are yet to be identified. The figures for 2021 are also not yet known.
Registers
The Cooperating Quality Registers consist of various registers. In more and more areas, doctors anonymously send their patients’ treatment results to a national registry. Using numbers, doctors can see whether the care they provide is improving or deteriorating, and whether their hospital is performing better or worse than the other. With that data, doctors can improve the quality of care, for example in the field of colorectal cancer, which was the first registry in the Netherlands. That has been happening for years. But at the moment, this collaboration between the registers offers an opportunity to see what impact the corona crisis has had on healthcare. So the picture is not yet complete. Further research should clarify for example by the RIVM.
Call
A call on plusonline showed that people themselves have doubts about the quality of care during the corona waves. People who were diagnosed with cancer at a late stage feel that they might have been on time in other circumstances. In Plus Magazine we take a closer look at these stories.
