New AIHW report reveals COVID-19 impact on health system

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New data from the Australian Institute of Health and Welfare (AIHW) shows the extent to which the COVID-19 pandemic has impacted hospital visits, procedures and other parts of the health system.

AIHW said it has reviewed the main impacts of the pandemic on Australia's health system, including hospitals, the Pharmaceutical Benefits Scheme (PBS), Medicare Benefits Schedule (MBS), mental health services and cancer screening.

"After the first cases of COVID-19 were recorded in Australia on 25 January 2020, many health services were suspended or required to operate in different ways," said AIHW spokesman Dr Adrian Webster.

"While this may have limited people’s access to and use of these services, in some cases, new or additional services were made available to Australians, including changes to the MBS."

The data shows fewer Australians presented to hospital emergency departments with injuries and less elective surgery was performed. Yet it also shows more people filled prescriptions and had telehealth medical consultations.

On hospitals, the average number of daily presentations to emergency departments declined substantially in the early stages of the COVID-19 pandemic.

According to AIHW, between the week starting 9 March and the week commencing 30 March, presentations fell by 38 per cent.

"The average daily number of presentations for injuries decreased from 5,800 in the week beginning 24 February to 3,400 in the week beginning 30 March," said Dr Webster.

"These trends coincided with increased restrictions on public and social gatherings and activities, including sporting events and travel restrictions, and availability of other health facilities."

The average daily presentations where COVID‑19 was suspected peaked at 785 in the week beginning 23 March. 

In the week starting 16 March 2020, 15,300 elective surgeries were performed in public hospitals. By the week starting 13 April, this had fallen to 4,800.

As restrictions eased, the number of surgeries increased - in the week starting 22 June, 14,200 surgeries were performed.

"The fall in surgeries during the peak of COVID-19 restrictions drove an overall decline for the year. In 2019–20, the number of surgeries was 9.2% lower than in 2018–19. While non-urgent elective surgeries fell by 3.5%, urgent surgeries increased by 3.5%," said Dr Webster.

At the same time, data from the early weeks of the pandemic has revealed a rush to fill prescriptions. The number of prescriptions dispensed in March 2020 was 23 per cent higher than the corresponding period in 2019.

AIHW said this rise was most significant for the group of medicines used to treat respiratory-related conditions such as asthma or chronic obstructive pulmonary disease.

It said this occurred after, and was separate from, a similar increase related to the bushfires earlier in the year.

"There was a shift away from face-to-face consultations to telephone and video conference consultations. For example, in April 2020, following the introduction of the new telehealth MBS items, 36% of GP consultations were delivered by telephone or video conference, while in April 2019, all recorded consultations were delivered face-to-face," said Dr Webster.

"Bulk-billing incentive payments rose from $55.6 million in March 2020 to an average of $130.0 million per month between April and August 2020."

On mental health, Dr Webster said, "Phone and online support organisations reported substantial increases in demand for their services during the COVID-19 pandemic."

"In the 4 weeks from 31 August to 27 September 2020, almost 83,500 calls were made to Lifeline (a 15.6% increase from the same time in 2019), Kids Helpline received more than 32,000 contacts (14.3% increase from the same time in 2019) and more than 27,500 calls were made to Beyond Blue’s general phone service (21.3% increase from the same time in 2019).

"Between 16 March 2020 and 27 September 2020, 7.2 million Medicare-subsidised mental health related services were delivered nationally ($791 million paid in benefits). Of these, 2.5 million services were delivered via telehealth."

The report also shows a dramatic fall in the number of mammograms conducted through BreastScreen Australia after they were suspended from late March 2020. They resumed in late April and early May.

"There were around 145,000 fewer screening mammograms performed through BreastScreen Australia in January to June 2020 compared with January to June 2018," said Dr Webster.

"The situation improved after restrictions were eased, with around 12,000 more screening mammograms performed through BreastScreen Australia in July to September 2020 compared with July to September 2018."