Working Paper: CEPR ID: DP16955
Authors: Thiemo Fetzer; Christopher Rauh
Abstract: This paper documents that the COVID-19 pandemic induced pressures on the health care system have significant adverse knock-on effects on the accessibility and quality of non-COVID-19 care. We observe persistently worsened performance and longer waiting times in A&E; drastically limited access to specialist care; notably delayed or inaccessible diagnostic services; acutely undermined access to and quality of cancer care. We find that providers under COVID-19 pressures experience notably more excess deaths among non-COVID related hospital episodes such as, for example, for treatment of heart attacks. We estimate there to be at least one such non-COVID-19 related excess death among patients being admitted to hospital for non-COVID-19 reasons for every 30 COVID-19 deaths that is caused by the disruption to the quality of care due to COVID-19. In total, this amounts to 4,003 non COVID-19 excess deaths from March 2020 to February 2021. Further, there are at least 32,189 missing cancer patients that should counterfactually have started receiving treatment which suggests continued increased numbers of excess deaths in the future due to delayed access to care in the past.
Keywords: health externalities; covid19; coronavirus; excess deaths; cancer; nhs; public health care
JEL Codes: I18; I10; D62; H12; H55
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| COVID-19 pandemic (H12) | decline in Accident and Emergency (A&E) attendances (I14) |
| COVID-19 pandemic (H12) | decline in non-emergency consultant-led treatments (I11) |
| COVID-19 pandemic (H12) | excess deaths among non-COVID hospital patients (I12) |
| COVID-19 deaths (I12) | non-COVID deaths due to care disruptions (I12) |
| COVID-19 pressures (H12) | waiting times and quality of cancer care (C41) |