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Missing Diagnoses during the COVID-19 Pandemic: A Year in Review

Centre for Research in Health Economics, Universitat Pompeu Fabra, 08002 Barcelona, Spain
Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, 08272 Barcelona, Spain
Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, 08007 Barcelona, Spain
Faculty of Medicine, University of Vic-Central University of Catalonia, 08500 Vic, Spain
Barcelona Economic Analysis Team, Department of Economics, Universitat de Barcelona, 08007 Barcelona, Spain
Centre of Organisation, Department of Primary Economics, University of Oxford, Oxford OX1 3UQ, UK
Research Group on Statistics, Econometrics and Health, Department of Economics, Universitat de Girona, 17004 Girona, Spain
Epidemiology and Public Health Networking Biomedical Research Centre, 28029 Madrid, Spain
Author to whom correspondence should be addressed.
Academic Editors: Belchin Kostov, Luis González-de Paz and Antoni Sisó-Almirall
Int. J. Environ. Res. Public Health 2021, 18(10), 5335;
Received: 18 March 2021 / Revised: 10 May 2021 / Accepted: 14 May 2021 / Published: 17 May 2021
(This article belongs to the Special Issue Primary Healthcare)
The COVID-19 pandemic has had major impacts on population health not only through COVID-positive cases, but also via the disruption of healthcare services, which in turn has impacted the diagnosis and treatment of all other diseases during this time. We study changes in all new registered diagnoses in ICD-10 groups during 2020 with respect to a 2019 baseline. We compare new diagnoses in 2019 and 2020 based on administrative records of the public primary health system in Central Catalonia, Spain, which cover over 400,000 patients and 3 million patient visits. We study the ratio of new diagnoses between 2019 and 2020 and find an average decline of 31.1% in new diagnoses, with substantial drops in April (61.1%), May (55.6%), and November (52%). Neoplasms experience the largest decline (49.7%), with heterogeneity in the magnitudes of the declines across different types of cancer diagnoses. While we find evidence of temporal variation in new diagnoses, reductions in diagnoses early in the year are not recouped by the year end. The observed decline in new diagnoses across all diagnosis groups suggest a large number of untreated and undetected cases across conditions. Our findings provide a year-end summary of the impact of the pandemic on healthcare activities and can help guide health authorities to design evidence-based plans to target under-diagnosed conditions in 2021. View Full-Text
Keywords: indirect impact; delayed diagnoses; COVID-19; SARS-CoV-2; access to healthcare indirect impact; delayed diagnoses; COVID-19; SARS-CoV-2; access to healthcare
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MDPI and ACS Style

Pifarré i Arolas, H.; Vidal-Alaball, J.; Gil, J.; López, F.; Nicodemo, C.; Saez, M. Missing Diagnoses during the COVID-19 Pandemic: A Year in Review. Int. J. Environ. Res. Public Health 2021, 18, 5335.

AMA Style

Pifarré i Arolas H, Vidal-Alaball J, Gil J, López F, Nicodemo C, Saez M. Missing Diagnoses during the COVID-19 Pandemic: A Year in Review. International Journal of Environmental Research and Public Health. 2021; 18(10):5335.

Chicago/Turabian Style

Pifarré i Arolas, Héctor; Vidal-Alaball, Josep; Gil, Joan; López, Francesc; Nicodemo, Catia; Saez, Marc. 2021. "Missing Diagnoses during the COVID-19 Pandemic: A Year in Review" Int. J. Environ. Res. Public Health 18, no. 10: 5335.

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