The COVID-19 pandemic and health care utilization : evidence from Austrian register data

The outbreak of the COVID-19 pandemic had an enormous impact on social and economic life and in particular. for human health care. In this paper, we document the impact of the COVID-19 pandemic and its accompanying policies on individual health care utilization. We use detailed administrative health registry data for Upper Austria for the years 2019 to 2021 and estimate the change in outpatient and inpatient health care utilization after the pandemic outbreak in March 2020 in a dynamic differences-in-difference setting. We document significant collateral damage to the health care system. While the number of outpatient visits and expenditures stabilized a few months after the outbreak, inpatient care decreased significantly and continued to decline during the subsequent quarantine periods. Chronically ill patients stocked up on necessary medications at the onset of the pandemic and the number of drug prescriptions steadily increased as the pandemic progressed. Spending on inpatient care and new diagnosis for cardiovascular disease and cancer dropped significantly below 2019 levels during the lockdown periods and many orthopedic, cataract, and vein procedures were either postponed or not performed. Finally, we find clear evidence of deteriorating mental health over the course of the pandemic.