Demographic risk factors, healthcare utilization, and mortality during the first year of the Covid-19 pandemic in Austria, Germany, and Italy

Abstract

At the population level, there is limited empirical evidence on the characteristics of individuals who were hospitalized because of Covid-19, the role of hospitalization in mortality risk, and how both evolved over time. Through the analysis of surveillance data for 7 million people in Austria, Germany, and Italy, we investigate: (1) the demographic characteristics and outcomes of individuals hospitalized because of Covid-19; and (2) the role of demographic risk factors and healthcare utilization (as measured by hospitalization) for the individual probability of dying because of Covid-19, in both cases comparing the period February to June 2020 with July 2020 to February 2021. We find that the demographic profile of individuals who were hospitalized or died because of Covid-19 is the same in both periods, except for a younger age profile for hospitalizations in the second period. Mortality differentials across countries result from the interaction of demographic risk factors and hospitalization at the individual level.

Keywords:

• Covid-19
• age
• sex
• hospitalization
• mortality

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 Simona Bignami-Van Assche is based in the Department of Demography, Université de Montréal, Canada. Daniela Ghio is based at Toronto Metropolitan University (Canada Excellence Research Chair in Migration and Integration). Nikolaos I. Stilianakis is based at the European Commission, Joint Research Centre (JRC) and also in the Department of Biometry and Epidemiology, University of Erlangen-Nuremberg, Germany.

2 Please direct all correspondence to Simona Bignami-Van Assche, Department of Demography, Université de Montréal, Montréal, H3C 3J7, Canada; or by email: [email protected].

3 Acknowledgements: We would like to thank Gianfranco Spiteri at ECDC for guiding us through the TESSy data access procedure and database preparation. We also received helpful comments from Ari Van Assche, Georges Reniers, Jack Sandberg, and two anonymous reviewers on earlier drafts of the manuscript.

4 Disclaimer: The information and views set out in this paper are those of the authors and do not necessary state or reflect the official opinion of the European Centre for Disease Prevention and Control (ECDC). Neither the European Union institutions and bodies nor any person acting on their behalf may be held responsible for the use which may be made of the information contained therein. The accuracy of the authors’ statistical analysis and the findings they report are not the responsibility of ECDC. ECDC is not responsible for conclusions or opinions drawn from the data provided. ECDC is not responsible for the correctness of the data and for data management, data merging, and data collation after provision of the data. ECDC shall not be held liable for improper or incorrect use of the data. The scientific output expressed does not imply a policy position of the European Commission. Neither the European Commission nor any person acting on behalf of the Commission is responsible for the use that might be made of this publication. For information on the methods and quality underlying the data used in this publication for which the source is neither Eurostat nor other Commission services, users should contact the authors. The designations employed and the presentation of material do not imply the expression of any opinion whatsoever on the part of the European Union concerning the legal status of any country, territory or of its authorities.