The effect of COVID-19 pandemic on non-deferrable diseases

Sara Muzzì, Paolo Berta, Pietro Giorgio Lovaglio and Stefano Verzillo

Research in Economics, 2026, vol. 80, issue 2

Abstract: The COVID-19 pandemic has profoundly disrupted healthcare systems globally, raising concerns about its impact on non-COVID-19 patients requiring immediate and intensive care. This paper investigates the effects of the pandemic on the quality of care for Acute Myocardial Infarction (AMI) and Stroke patients in Lombardy, Italy. Taking advantage of rich administrative data (hospital discharge data, emergency call and mortality registries) and leveraging the national lockdown as an exogenous shock in a quasi-experimental framework, we estimate the causal effects of COVID-19 on in- and out-of-hospital mortality rates, hospitalizations, and ambulance response times to discuss their implications for the regional healthcare system. We employed a Differences-in-Differences approach. In this way, this paper assesses the national healthcare service’s ability to respond to an emergency situation promptly. Our results reveal a 60% increase in daily out-of-hospital deaths during the pandemic and significant delays in ambulance response times, with an average increase of 11 min for both AMI and Stroke patients. In-hospital mortality remained stable, suggesting that delays in ambulance transport did not directly affect patients who reached the hospital, who were fewer in number. These findings highlight the critical need for policies aimed at maintaining rapid emergency response capacity during health crises, ensuring that time-sensitive care for non-pandemic-related conditions is not compromised.

Keywords: COVID-19; AMI; Stroke; In-hospital mortality; Out-of-hospital mortality; Ambulance calls (search for similar items in EconPapers)
JEL-codes: D21 D22 I11 I18 L22 L33 (search for similar items in EconPapers)
Date: 2026
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Persistent link: https://EconPapers.repec.org/RePEc:eee:reecon:v:80:y:2026:i:2:s1090944326000141

DOI: 10.1016/j.rie.2026.101126

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