Delayed Acute Care and Excess Mortality: Effects of Deferred Diagnoses and Treatment among Patients with Hypertension and Heart Disease

Postponement of care for cardiovascular diseases, such as high blood pressure, vascular, coronary and heart diseases, has contributed significantly to excess mortality in the Netherlands. The results of this study suggest that a significant part of the excess mortality in 2021 may be contributed to the 'delay effect' in hospitals during COVID-19 in patients who required acute or non-acute angioplasty in the Netherlands in 2020 or 2021. The main driver behind this result appears to be the postponement of non-acute angioplasty. In addition, there were small shifts in the decision criteria not to perform non-acute angioplasty, for example after angina pectoris, which later led to a larger number of acute angioplasty treatments after more serious conditions such as cardiac arrest. Prioritization and treeage practices in hospitals can have significant impacts on morbidity and mortality. During the next pandemic, these effects must be taken into account in policy considerations.