The pandemic was a huge stress test for the health system: although emergency medicine recorded fewer cases such as heart attacks and strokes, crisis consultations with psychiatrists increased significantly at certain times. On the other hand, there was a large drop in elective treatments such as orthopaedic surgery and cancer screening, although these were made up as the pandemic progressed. In children, certain basic vaccinations were carried out much less frequently, running counter to the goal of high vaccination coverage. These are the findings of the new Helsana Report with data-based facts on basic healthcare during the coronavirus pandemic.
The pandemic itself served as a reminder to society of the importance of an intact health system. Swiss healthcare providers were influenced not only by the virus, but also by state interventions and their impact. It was nevertheless essential for medical care to be maintained at all times. The new Helsana Report takes a critical look at healthcare provision in 2020 in the context of coronavirus and provides data-based facts.
Contrary to fears, the costs borne by basic insurance in 2020 remained stable. This was due to the ban on non-urgent treatments by the federal government and to individual risk assessments by the public, both of which appear to have had an inhibiting effect on demand. The decline in costs was particularly pronounced in Ticino, French-speaking Switzerland and in rural areas. Telephone and video consultations played an important role in maintaining service provision – for example, appointments with GPs were held up to four times as often during the first wave, and in the second wave almost twice as often. Overall, a larger proportion of the younger population made use of a medical service (e.g. doctor’s appointment, medication or COVID testing). For elderly population groups, the pandemic led to a more intensive provision of care combined with an increase in costs for those over 70 years of age.
In 2020, significantly fewer heart attacks and cardiac emergencies were handled in hospitals than in the previous year. Based on Helsana data, it can be assumed that many of those affected by mild or unspecific symptoms received insufficient care and carry a certain risk of negative long-term consequences. At the same time, however, the pandemic situation led to a reduction in stress for certain parts of the population. Social distancing and improved hygiene also resulted in fewer infectious diseases, such as influenza, which is considered a risk factor for heart attacks and strokes.
In general, around the same number of services were provided in outpatient psychiatry and psychology as in the previous year. However, the first lockdown saw a sharp increase in outpatient crisis intervention provided by psychiatrists, although this service was provided less frequently by GPs. In the area of mental health emergencies, the possibility of telephone and video interventions facilitated access to psychiatrists. Children, adolescents, young adults and those of retirement age sought psychiatric help more frequently than other age groups. These groups appear to have been affected more strongly by the pandemic and its health and social impact.
An elective treatment is a non-urgent treatment or operation that is nevertheless indicated for medical reasons. The ban on treatment during the first wave of the pandemic led in the short term to a marked decline in orthopaedic procedures and cancer screening. Both were made up to a large extent during the subsequent months. On the other hand, there was a noticeable reluctance in terms of vaccination during the pandemic and fewer basic vaccinations were administered overall than in 2020. Vaccinations in young children take place within the framework of the overall monitoring of their development and should not be postponed.
The Coronavirus Report provides facts and input for more effective management of care in both normal and extraordinary situations. The analysis is based on the benefit data of about 1.4 million persons covered by compulsory health insurance (OKP) by the Helsana Group from 2018 to 2020. All figures were extrapolated based on the risk compensation statistics for the Swiss population as a whole.
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