OBJECTIVES:

Literature suggests an impact of the COVID-19 pandemic on mental health. However, the impact on healthcare resource use (HCRU) among patients newly-diagnosed with mood/affective disorders remains unclear.

METHODS:

Adults with ≥1 inpatient/outpatient diagnosis of a mood/affective disorder (ICD-10 F30-F39) from 01/01/2018–31/12/2020 were identified from a German claims dataset. A 18-month washout period was applied to ensure incidence of the diagnosis. HCRU outcomes were observed during a 6-month follow-up period. Patients were broken down into two cohorts based on whether their follow-up period fell into the pre-COVID or COVID period (cut-off 01/04/2020); patients with both pre-COVID and COVID periods were excluded.

RESULTS:

A total of 132,103 patients were identified (pre-COVID: 97,189; COVID: 34,914). While the mean age was equal in both cohorts (54.1 years), the proportion of females was significantly lower in the COVID cohort (62.5% vs. 63.4%, p=0.002).

The share of patients hospitalized in relation to a diagnosis of mood/affective disorder was smaller during the COVID period (14.8% vs. 17.1%, p<0.001), and the average number of related hospital days during follow-up was significantly lower in the COVID cohort (4.96 vs. 5.73 days, p<0.001). The hospitalization rate and number of hospital days were particularly low for patients diagnosed in Q4 2020 (12.9%; 4.53 days).

The number of mood/affective disorder-related outpatient visits during the follow-up was similar between both cohorts, except for a remarkably higher number of visits among patients diagnosed in Q2 2020. The proportion of patients with sick leaves was significantly lower in the COVID cohort (37.0% vs. 35.7%, p<0.001), however differences in the number of sick days were not significant (18.1 vs. 17.6 days, p=0.052).

CONCLUSIONS:

The HCRU of people newly-diagnosed with mood/affective disorders has shifted during the COVID-19 pandemic. Further research is needed to assess the impact of the observed shift on severity and long-term outcomes.