Physiotherapy use is increased for up to nine months after receiving respiratory support for COVID-19

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

30 dagers overlevelse og reinnleggelse etter sykehusinnleggelse. Resultater for 2019

Folkehelseinstituet beregner kvalitetsindikatorene “risikojustert sannsynlighet for overlevelse innen 30 dager eer innleggelse på sykehus” og “risikojustert sannsynlighet for reinnleggelse innen 30 dager eer utskrivning fra sykehus”. Indikatorene beregnes årlig og inngår i det nasjonale kvalitetsindikatorsystemet som forvaltes av Helsedirektoratet. NPR har levert pasientadministrative data fra alle landets sykehus. FHI har koblet innleggelser og innhentet eventuell dødsdato fra Folkeregisteret. I denne rapporten rapporten presenteres resultater for hvert enkelt sykehus, helseforetak (HF) og regionalt helseforetak (RHF) for begge indikatortypene. For reinnleggelse rapporteres det også per bostedskommune, fylke og Kommune-Stat-Rapporterings (KOSTRA)-gruppe. Beregningene tar hensyn til alder, kjønn, antall tidligere innleggelser og komorbiditet for å sikre mer valid sammenligningen av rapporteringsenhetene

Pandemic trends in health care use : From the hospital bed to self-care with COVID-19

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%

Scenarier for helsetjenestebehov for flyktninger fra Ukraina

Innledning Russlands invasjon av Ukraina har ført til en umiddelbar økning i antall flyktninger til andre land i Europa. En slik situasjon krever økt beredskap hos helsetjenesten, og økt beredskap krever oppdaterte og pålitelige data for beslutningsgrunnlag. Denne rapporten presenterer ulike scenarier for bruk av helsetjenester for flyktninger fra Ukraina i Norge framover. Vi bruker tall på registrerte asylsøkere frem til 10. mai som anslag på demografisk sammensetning, og kombinerer dette med UDI sine scenarier for antall flyktninger framover, samt det vi vet om helsetjenestebruk blant norskfødte i Norge etter alder og kjønn. Metode Vi tar utgangspunkt i scenariene fra UDI om antall flyktninger vi venter at skal komme og når de kommer. Vi kombinerer det med informasjon om månedlig helsetjenestebruk for norskfødte etter alder og kjønn. For informasjon om hvor mange som har kommet til nå, samt alders- og kjønnsfordelingen for dem, har vi brukt tall fra UDI (2022). Resultat Selv konservative estimater for antall flyktninger og deres forventede helsetjenestebruk gir markant økning i behovet for helsetjenester. Dette vil være spesielt merkbart i områder hvor helsetjenestene allerede er nær kapasitetsgrensene. Scenariene viser større økning i allmennlegebruk enn økning i liggedøgn på sykehus. Diskusjon Scenariene vi har sett på i denne rapporten er basert på strenge og foreløpige forutsetninger. Etter hvert som utviklingen skrider frem vil kunnskapsgrunnlaget øke, og vi vet mer om hva vi kan forvente. Videre analyser og utforskning av scenarier er derfor interessant også fremover. Vi har beskrevet situasjonen for Norge som helhet. Imidlertid er det store forskjeller mellom kommuner i hvor mange flyktninger de skal bosette og ha i akuttinnkvartering. Det er grunn til å anta at kommuner som tar imot mange flyktninger relativt til sitt innbyggertall, vil oppleve betydelig større belastning for helsetjenestene enn kommuner som tar imot færre. Kommuner med mindre allmennlegekapasitet i utgangspunktet vil også oppleve større belastning. Det er grunn til å tro at belastningen på helsetjenesten knyttet til akuttinnkvartering kan være større enn ved bosetning. Konklusjon Scenariene viser at betydelige flyktningetall vil kreve større kapasitet i helsetjenestene. Flere personer i landet med mulige helsetjenestebehov vil gi en økning i helsetjenestebruk i kommuner som tar imot flyktninger. Økningen er særlig stor for allmennlegetjenester. For allmennlegetjenesten gir forutsetning om lik helsetjenestebruk som norskfødte med samme kjønn og alder, og midtscenariet fra UDI, en økning i allmennlegetjenester i oktober 2022 tilsvarende 40 allmennleger

Pandemic trends in health care use: From the hospital bed to self-care with COVID-19

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 26(th), 2020 –February 16(th), 2021 (1(st) wave dominated by the Wuhan strain), February 17(th)–July 10(th), 2021 (2(nd) wave dominated by the Alpha variant), July 11(th)–December 27(th), 2021 (3(rd) wave dominated by the Delta variant), and December 28(th), 2021 –January 14(th), 2022 (4(th) 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%

Impacts of mild COVID-19 on elevated use of primary and specialist health care services: A nationwide register study from Norway

AimTo explore the temporal impact of mild COVID-19 on need for primary and specialist health care services.MethodsIn 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 SARS-CoV-2 (non-hospitalization, i.e. mild COVID-19) and patients with a negative test (no COVID-19).ResultsWe 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.ConclusionMild 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