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Pandemic Pressures and Public Health Care : Evidence from England


  • Fetzer, Thiemo

    (University of Warwick, CAGE and CEPR.)

  • Rauh, Christopher

    (University of Cambridge, Trinity College Cambridge, CEPR)


This paper documents that the COVID-19 pandemic induced pressures on the health care system have significant adverse knock-on effects on the accessibility and quality of non-COVID-19 care. We observe persistently worsened performance and longer waiting times in A&E; drastically limited access to specialist care; notably delayed or inaccessible diagnostic services; acutely undermined access to and quality of cancer care. We find that providers under COVID-19 pressures experience notably more excess deaths among non-COVID related hospital episodes such as, for example, for treatment of heart attacks. We estimate there to be at least one such non-COVID-19 related excess death among patients being admitted to hospital for non-COVID-19 reasons for every 30 COVID-19 deaths that is caused by the disruption to the quality of care due to COVID-19. In total, this amounts to 4,003 non COVID-19 excess deaths from March 2020 to February 2021. Further, there are at least 32,189 missing cancer patients that should counterfactually have started receiving treatment which suggests continued increased numbers of excess deaths in the future due to delayed access to care in the past.

Suggested Citation

  • Fetzer, Thiemo & Rauh, Christopher, 2022. "Pandemic Pressures and Public Health Care : Evidence from England," The Warwick Economics Research Paper Series (TWERPS) 1395, University of Warwick, Department of Economics.
  • Handle: RePEc:wrk:warwec:1395

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    1. Mitze, Timo & Kosfeld, Reinhold & Rode, Johannes & Wälde, Klaus, 2020. "Face masks considerably reduce COVID-19 cases in Germany," Publications of Darmstadt Technical University, Institute for Business Studies (BWL) 124130, Darmstadt Technical University, Department of Business Administration, Economics and Law, Institute for Business Studies (BWL).
    2. Mitze, Timo & Kosfeld, Reinhold & Rode, Johannes & Wälde, Klaus, 2020. "Face masks considerably reduce COVID-19 cases in Germany," Publications of Darmstadt Technical University, Institute for Business Studies (BWL) 124587, Darmstadt Technical University, Department of Business Administration, Economics and Law, Institute for Business Studies (BWL).
    3. Pablo D. Fajgelbaum & Amit Khandelwal & Wookun Kim & Cristiano Mantovani & Edouard Schaal, 2021. "Optimal Lockdown in a Commuting Network," American Economic Review: Insights, American Economic Association, vol. 3(4), pages 503-522, December.
    4. Etheridge, Ben & Spantig, Lisa, 2020. "The gender gap in mental well-being during the Covid-19 outbreak: evidence from the UK," ISER Working Paper Series 2020-08, Institute for Social and Economic Research.
    5. Korinek, Anton & Bethune, Zachary, 2020. "COVID-19 Infection Externalities: Trading Off Lives vs. Livelihoods," CEPR Discussion Papers 14596, C.E.P.R. Discussion Papers.
    6. Jason Abaluck & Laura H Kwong & Ashley Styczynski & Md. Ashraful Haque & Alamgir Kabir & Ellen Bates-Jeffries & Emily Crawford & Jade Benjamin-Chung & Salim Benhachmi & Shabib Raihan & Shadman Rahman , 2021. "Normalizing Community Mask-Wearing: A Cluster Randomized Trial in Bangladesh," Cowles Foundation Discussion Papers 2284, Cowles Foundation for Research in Economics, Yale University.
    7. David Adam, 2022. "The pandemic’s true death toll: millions more than official counts," Nature, Nature, vol. 601(7893), pages 312-315, January.
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    Cited by:

    1. Fetzer, Thiemo & Rauh, Christopher & Schreiner, Clara, 2024. "The hidden toll of the pandemic: Excess mortality in non-COVID-19 hospital patients," Journal of Health Economics, Elsevier, vol. 95(C).
    2. Wolfgang Frimmel & Gerald J. Pruckner, 2024. "The COVID-19 pandemic and health care utilization: Evidence from Austrian register data," Economics working papers 2024-03, Department of Economics, Johannes Kepler University Linz, Austria.
    3. Lukas Freund & Hanbaek Lee & Pontus Rendahl, 2023. "The Risk-Premium Channel of Uncertainty: Implications for Unemployment and Inflation," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 51, pages 117-137, December.
    4. Kai Fischer, 2023. "Skilled Labour Migration and Firm Performance: Evidence from English Hospitals and Brexit," CESifo Working Paper Series 10747, CESifo.
    5. Bergeot, Julien & Jusot, Florence, 2024. "How did unmet care needs during the pandemic affect health outcomes of older European individuals?," Economics & Human Biology, Elsevier, vol. 52(C).

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    More about this item


    Health ; Externalities ; COVID-19 ; Coronavirus ; Excess deaths ; Cancer ; NHS ; Public health care JEL Classification: I18 ; I10 ; D62 ; H12 ; H55;
    All these keywords.

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I10 - Health, Education, and Welfare - - Health - - - General
    • D62 - Microeconomics - - Welfare Economics - - - Externalities
    • H12 - Public Economics - - Structure and Scope of Government - - - Crisis Management
    • H55 - Public Economics - - National Government Expenditures and Related Policies - - - Social Security and Public Pensions

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