Register-based study on health care use of people with and without dementia and COVID-19

Abstract Background The use of health services does not vary only according to needs but also according to the availability of services. Due to COVID-19 pandemic in spring 2020, health care use was partly restricted in Finland. As it was suggested that people with dementia could be the most severely affected group by the restriction and distancing policies, this study explored the changes in the use of health care among people 70+ with dementia in the pre-COVID years 2018, 2019, and 2020, when the pandemic started. Methods The study population for register-based study was retrieved from the Finnish Population Register and consisted of all people aged 70 and older in Finland in 2018, 2019, and 2020 (N 1 032 000). For these individuals, data were linked from care registers, including information on their health care visits and inpatient days. Descriptive statistical analyses were performed separately for each month in the study years and three age groups (70-79, 80-89, and 90+). Results Regardless of the dementia status, almost nine out of ten used outpatient health care services. Of community-dwelling people, every third of people with dementia and around 15% of people without dementia used inpatient health care. Between the study years, the proportion of inpatient care users decreased, especially among people aged 90+, and those who had dementia. People aged 70-89 with dementia, followed by people aged 80-89 without dementia, had the highest number of outpatient care visits until March 2020 when visits decreased drastically for all groups. Visits increased again towards the end of the year. Conclusions People with dementia living at home used inpatient care more than those without dementia. As the number of people with dementia increases, it may increase the demand for inpatient care. The COVID-19 pandemic temporarily decreased the use of health care services. This decrease is likely due to the system's restrictions on access to care, not to people's sudden decrease in needs.