Pandemic economics 3

Einleitung / Introduction

Nosocomial infections are infectious diseases passed on in medical facilities. In Germany, up to 600,000 patients get a nosocomial infection per year. A central element in controlling the spread is hygiene. With the onset of the COVID-19-pandemic, German hospitals tightened up their hygiene regulations, which may have led to an increase in hygiene. At the same time, the pandemic imposed additional physical and mental burden on medical staff and institutions, which suggests a negative impact on established hygiene-related processes. In this paper, we examine which effect predominates. In doing so, we analyse the development of nosocomial infections in 2020 in Germany based on detailed patient-level data. We use matching to control for patient selection during the Covid-19-pandemic. Our results show large increases in the nosocomial infections rate of 0.6 pp. in the first wave of the pandemic and 1 pp. in the second wave compared with the average value of 5.6% in previous years. Thus, the physical and mental burden due to the pandemic seems to outweigh the tightening up of hygiene regulations.

AutorInnen

Boris Augurzky, RWI Essen

Anne Mensen, RWI Essen

Simon Decker, RWI Essen

Einleitung / Introduction

The COVID-19 pandemic has caused economic shock waves across the globe. Much research addresses direct health implications of an infection, but to date little is known about how this shapes lasting economic effects. This paper estimates the workplace productivity effects of COVID-19 by studying performance of soccer players after an infection. We construct a dataset that encompasses all traceable infections in the elite leagues of Germany and Italy. Relying on a staggered difference-in-differences design, we identify negative short- and longer-run performance effects. Relative to their preinfection outcomes, infected players’ performance temporarily drops by more than 6%. Over half a year later, it is still around 5% lower. The negative effects appear to have notable spillovers on team performance. We argue that our results could have important implications for labor markets and public health in general. Countries and firms with more infections might face economic disadvantages that exceed the temporary pandemic shock due to potentially long-lasting reductions in productivity.

AutorInnen

Kai Fischer, Heinrich Heine University

James Reade, University of Reading

Einleitung / Introduction

In this paper we document the impact of the Covid-19 pandemic on individual healthcare utilization and aim to quantify potential collateral damages of policy interventions such as lockdowns or physical distancing measures on invididual health and health behavior.

Methode / Method

We use detailed administrative register data on health care utilization for Upper Austria for the years 2019 and 2020. The disaggregated data include information on the outpatient (doctor visits and expenses, medication expenses on ATC-level) and inpatient sector (hospital days, diagnosis on ICD10-level). We implement an event-study design on monthly level with January as the baseline month and March as the first month of the pandemic. In order to control for seasonality, we use health care utilization in 2019 as a control period.

Ergebnisse / Results

Outpatient doctor visits declined by approximately 50 percent during March and May, but recovered after the lockdown. This reduction was not caught up afterwards. An equivalent behavioral response of patients during the second wave starting in October was absent except for elderly people. We find similar patterns across all types of doctors (e.g. GP, ENT specialists…) but quantitatively more pronounced for areas with a more preventative character. Medication expenses strongly increased in March 2020 due to hoarding behavior of particularly chronically ill patients with a subsequent fall in the following months of similar magnitude, hence we find no evidence of waste of hoarded medication. We also document heterogeneity along gender, age and socio-economic status. In particular younger people increased spending on psychotropics signficiantly during the second wave. For the inpatient sector, hospital treatments were reduced by 70 percent during the first and to a similar degree in the second wave of the pandemic. While hospital treatments recovered during the two waves, the length of hospital stays remained significantly reduced throughout the pandemic. This pattern is similar for any type of hospital admissions and diagnosis except for birth-related hospital stays. A closer look at disaggregated hospital data reveals, that particularly elective treatments were delayed substantially.

Zusammenfassung / Conclusion

Using administrative data and an event-study design, we document a strong impact of the Covid-pandemic on individual health care utilization in the inpatient and outpatient sector. Reductions in utilization was particularly pronounced in areas of preventative care. This allows us a quantification of short-run collateral damages of policy interventions to fight the Covid-19 pandemic.

AutorInnen

Wolfgang Frimmel, Johannes Kepler Universität Linz

Gerald Pruckner, Johannes Kepler Universität Linz

Einleitung / Introduction

The covid-pandemic and the corresponding governmental response have had substantial social and economic consequences. First insights suggest that the pandemic and the containment measures had a large impact on people’s life satisfaction and mental health. However, a nuanced picture of well-being trajectories throughout the pandemic is still lacking. Therefore, the objective of this study was two-fold. First, to shed light on the development of well-being across the pandemic and relevant subgroups within countries in Europe. Second, to estimate what role the stringency of government measures played for well-being.

Methode / Method

The analysis is based on eight waves from the ECOS survey, a multi-country survey designed for examining COVID-related societal issues. Each wave included representative samples of around 1,000 citizens from seven European countries. Well-being was measured using the five-dimensional ICEpop CAPability measure for Adults (ICECAP-A). The dataset was complemented by country-level data on COVID cases and deaths, and government stringency, using the Oxford Covid-19 Government Response Tracker (OxCGRT). The analysis sample consisted of 49,767 observations with 39,027 observations stemming from individuals, who participated at least twice. First, mean score differences compared to the first wave in the five well-being dimensions of the ICECAP-A (attachment, stability, achievement, enjoyment, and autonomy) were calculated for all countries, waves, and subgroups, and graphically analysed. In a second step, the ICECAP-A dimension scores were separately regressed on the government stringency index using the panel sample and fixed effects ordered logit models, controlling for COVID deaths at time of survey participation and other covariates.

Ergebnisse / Results

Comparing later waves to the first wave (April 2020), citizens generally scored higher on the stability dimension (mean differences up to -0.3 on a scale from 1, best, to 4, worst), while the largest decrements were found for the attachment and enjoyment dimensions (up to + 0.25). Differences were most pronounced in age, income, and health status subgroups. Regression results indicated that on average government stringency did not have a clear and significant relationship with the well-being dimensions of the ICECAP-A. This changed when examining the effect in later waves, relevant subgroups, and countries separately. In some subgroup, positive, effects were found on the stability and attachment dimensions.

Zusammenfassung / Conclusion

The obtained insights on well-being trajectories throughout the pandemic and the impact of the stringency of governmental measures on well-being in different groups in society is important for informing government responses to both the ongoing pandemic and potential future health crises.

AutorInnen

Sebastian Himmler, Erasmus School of Health Policy & Management

Job van Exel, Erasmus School of Health Policy & Management

Werner Brouwer, Erasmus School of Health Policy & Management