How COVID-19 changed the way Australians used health services in 2019-20
Fewer Australians presented to hospital emergency departments with injuries and less elective surgery was performed, but more people filled prescriptions and had telehealth medical consultations after COVID-19 restrictions were first implemented in 2020, according to new data from the Australian Institute of Health and Welfare (AIHW).
As 2020 comes to an end, the AIHW has reviewed the main impacts of the COVID-19 pandemic on the Australian health system in a series of reports and updates released today. The releases include the annual MyHospitals emergency department and elective surgery updates for 2019–20 and special reports about the Pharmaceutical Benefits Scheme (PBS), Medicare Benefits Schedule (MBS), mental health services and cancer screening during COVID-19 and an update of hospital hand hygiene data.
‘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.’
MyHospitals update: Emergency department care 2019–20(Includes State, Territory and local hospital data)
The average number of daily presentations to emergency departments declined substantially in the early stages of the COVID-19 pandemic. Between the week starting 9 March and the week commencing 30 March, presentations fell by 38%.
‘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,‘ Dr. Webster said.
‘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. The number of presentations to emergency departments related to COVID-19 does not reflect the number of diagnosed COVID-19 cases in Australia.
MyHospitals update: Elective surgery waiting times 2019–20 (Includes State, Territory and local data)
To avoid overwhelming the hospital system and protect the supply of personal protective equipment, non-urgent elective surgery was suspended nationally from 26 March 2020 and a staged reintroduction began from 27 April 2020.
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%,’ Dr. Webster said.
Impacts of COVID-19 on Medicare Benefits Schedule and Pharmaceutical Benefits Scheme service use (Includes State and Territory data)
The number of prescriptions dispensed in March 2020 was 23% higher than in March 2019. This rise was most significant for the group of medicines used to treat respiratory related conditions such as asthma or chronic obstructive pulmonary disease. 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,’ Dr. Webster said.
‘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.’
Mental health services and COVID-19
Data across a range of mental health related services show heightened service usage since 20 March 2020 when COVID-19 pandemic restrictions were introduced.
‘Phone and online support organisations reported substantial increases in demand for their services during the COVID-19 pandemic,’ Dr. Webster said.
‘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.
In September 2020 (31 August to 27 September 2020), the number of services delivered was 15% higher than in the same period in September 2019. In the 4 weeks to 27 September 2020, the number of mental health-related prescriptions dispensed under the PBS was 5.9% higher than in the same period in 2019.
Cancer Screening and COVID-19 PART 2 (Includes State and Territory data)
To protect clients and health care workers from the spread of COVID-19, screening mammograms delivered through BreastScreen Australia were suspended from late March 2020, before resuming in late April/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,’ Dr. Webster said.
‘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.’
Hand hygiene (Includes State, Territory and local data)
Compliance with hand hygiene standards in Australian hospitals is generally good, with national benchmarks routinely met. This continued during the COVID-19 pandemic, with the latest data suggesting improvements in the early part of 2020 against already high standards.
‘Hand hygiene in hospitals generally refers to the washing of hands or use of alcohol-based rubs by healthcare workers,’ Dr. Webster said.
‘In the most recent audit period (1st April to 30th June 2020), the national hand hygiene compliance rate was 88.2%, higher than the benchmark of 80%.’
The compliance rate for 5 hand hygiene ‘moments’: was 85.3% before touching a patient; 91.5% before a procedure; 93.3% after a procedure or body fluid exposure risk; 91.2% after touching a patient; and 83.4% after touching a patient’s surroundings.
The AIHW released several reports this year containing information relevant to the COVID-19 pandemic. A full list can be found on the AIHW’s COVID-19 Resources page.