OBJECTIVES: To quantify the impact of COVID-19 and impact of health inequality on IPF service provision from a healthcare utilisation perspective.

METHODS: Patients were identified on admission to hospital in England with a primary diagnosis of idiopathic pulmonary fibrosis (IPF) (ICD-10 Code, J841). The observational period was April 2016 to March 2021 with the earliest hospitalisation set as the index date. The Impact of Health Inequality on patient utilisation of health care was defined by indices of multiple deprivation, focusing on the most deprived (0-25%) and the least deprived population (75-100%) within the identified IPF cohort. The results reflect healthcare utilisation throughout the observational period, in addition, post index impact of health inequality for pre and post COVID-19 activity.

RESULTS: There were 194,575 inpatient spells recorded, 102,755 were non elective. There were 98,008 emergency attendances and 999,120 outpatient appointments. In the 12 months (April 2019 – March 2020) prior to the 1^st national lockdown in the UK there was 10,060 admissions costing £24,870,440 (primary diagnosis J841). April 2020 to March 2021 saw a reduction in activity to 5,885 admissions costing £16,683,470. First attendance at outpatient appointments following initial admission for IPF fell from 275 in April 2019 to 7 in 2020, all 7 first outpatient appointments were conducted virtually. Between April 2019 and March 2021 the least deprived quartile accessed outpatient services in greater numbers than those from the most deprived quartile (14,835 vs 16,905).

CONCLUSIONS: As we have seen, COVID-19 has had a significant impact on admission numbers and outpatient appointments. Moreover, first outpatient appointments following an initial IPF admission have significantly reduced as a result of service interruption.