{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T19:59:53Z","timestamp":1772135993932,"version":"3.50.1"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T00:00:00Z","timestamp":1635811200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T00:00:00Z","timestamp":1635811200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Earlier in 2020, seven Italian regions, which cover 62% of the Italian population, set up the Mimico-19 network to monitor the side effects of the restrictive measures against Covid-19 on volumes and quality of care. To this aim, we retrospectively analysed hospital discharges data, computing twelve indicators of volume and performance in three clinical areas: cardiology, oncology, and orthopaedics. Weekly indicators for the period January\u2013July 2020 were compared with the corresponding average for 2018\u20132019; comparisons were performed within 3 sub-periods: pre-lockdown, lockdown, and post-lockdown. The weekly trend of hospitalisations for ST-segment elevation myocardial infarction (STEMI) showed a 40% reduction, but the proportion of STEMI patients with a primary PTCA did not significantly change from previous years. Malignant neoplasms surgery volumes differed substantially by site, with a limited reduction for lung cancer (&lt;\u200920%) and greater declines (30\u201340%) for breast and prostate cancers. The percentage of timely surgery for femoral neck in the elderly remained constantly higher than the previous 2\u00a0years whereas hip and knee replacements fell dramatically. Hospitalisations have generally decreased, but the capacity of a timely and effective response in time-dependent pathways of care was not jeopardized throughout the period. General trends did not show important differences across regions, regardless of the different burden of Covid-19. Preventive and primary care services should adopt a pro-active approach, moving towards the identification of at-risk conditions that were neglected during the pandemic and timely addressing patients to the secondary care system.<\/jats:p>","DOI":"10.1038\/s41598-021-00982-4","type":"journal-article","created":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T07:03:37Z","timestamp":1635836617000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Indirect impact of Covid-19 on hospital care pathways in Italy"],"prefix":"10.1038","volume":"11","author":[{"given":"Teresa","family":"Spadea","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6031-1009","authenticated-orcid":false,"given":"Chiara","family":"Di 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COVID-19 Integrated Surveillance Data in Italy, https:\/\/www.epicentro.iss.it\/en\/coronavirus\/sars-cov-2-dashboard (2021)."},{"key":"982_CR2","doi-asserted-by":"publisher","first-page":"2083","DOI":"10.1093\/eurheartj\/ehaa409","volume":"41","author":"S De Rosa","year":"2020","unstructured":"De Rosa, S. et al. Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 era. Eur. Heart J. 41, 2083\u20132088. https:\/\/doi.org\/10.1093\/eurheartj\/ehaa409 (2020).","journal-title":"Eur. Heart J."},{"key":"982_CR3","doi-asserted-by":"publisher","first-page":"e391","DOI":"10.1002\/bjs.11832","volume":"107","author":"F Di Marzo","year":"2020","unstructured":"Di Marzo, F. et al. Impact of SARS-CoV-2 on elective surgical volume in Tuscany: Effects on local planning and resource prioritization. Br. J. Surg. 107, e391\u2013e392. https:\/\/doi.org\/10.1002\/bjs.11832 (2020).","journal-title":"Br. J. Surg."},{"key":"982_CR4","unstructured":"Fabiani, M. et al. Il case fatality rate dell\u2019infezione SARS-CoV-2 a livello regionale e attraverso le differenti fasi dell\u2019epidemia in Italia [The case fatality rate of SARS-CoV-2 infection at regional level, through the different epidemic phases in Italy] (2021)."},{"key":"982_CR5","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1016\/j.resuscitation.2020.12.020","volume":"159","author":"E Baldi","year":"2021","unstructured":"Baldi, E. et al. Out-of-hospital cardiac arrest incidence in the different phases of COVID-19 outbreak. Resuscitation 159, 115\u2013116. https:\/\/doi.org\/10.1016\/j.resuscitation.2020.12.020 (2021).","journal-title":"Resuscitation"},{"key":"982_CR6","doi-asserted-by":"publisher","first-page":"100055","DOI":"10.1016\/j.lanepe.2021.100055","volume":"3","author":"G Campo","year":"2021","unstructured":"Campo, G. et al. In- and out-of-hospital mortality for myocardial infarction during the first wave of the COVID-19 pandemic in Emilia-Romagna, Italy: A population-based observational study. Lancet Reg. Health\u2014Eur. 3, 100055. https:\/\/doi.org\/10.1016\/j.lanepe.2021.100055 (2021).","journal-title":"Lancet Reg. Health\u2014Eur."},{"key":"982_CR7","doi-asserted-by":"publisher","first-page":"100662","DOI":"10.1016\/j.ijcha.2020.100662","volume":"31","author":"S Carugo","year":"2020","unstructured":"Carugo, S. et al. Management of acute coronary syndromes during the COVID-19 outbreak in Lombardy: The \u201cmacro-hub\u201d experience. Int. J. Cardiol. Heart Vasc. 31, 100662. https:\/\/doi.org\/10.1016\/j.ijcha.2020.100662 (2020).","journal-title":"Int. J. Cardiol. Heart Vasc."},{"key":"982_CR8","doi-asserted-by":"publisher","first-page":"1881","DOI":"10.1001\/jamaoncol.2020.5403","volume":"6","author":"HE Hartman","year":"2020","unstructured":"Hartman, H. E. et al. Integrated survival estimates for cancer treatment delay among adults with cancer during the COVID-19 pandemic. JAMA Oncol. 6, 1881\u20131889. https:\/\/doi.org\/10.1001\/jamaoncol.2020.5403 (2020).","journal-title":"JAMA Oncol."},{"key":"982_CR9","doi-asserted-by":"publisher","first-page":"344","DOI":"10.19191\/ep20.5-6.s2.136","volume":"44","author":"P Mantellini","year":"2020","unstructured":"Mantellini, P. et al. Oncological organized screening programmes in the COVID-19 era: An Italian survey on accrued delays, reboot velocity, and diagnostic delay estimates. Epidemiol. Prev. 44, 344\u2013352. https:\/\/doi.org\/10.19191\/ep20.5-6.s2.136 (2020).","journal-title":"Epidemiol. Prev."},{"key":"982_CR10","doi-asserted-by":"publisher","first-page":"m4087","DOI":"10.1136\/bmj.m4087","volume":"371","author":"TP Hanna","year":"2020","unstructured":"Hanna, T. P. et al. Mortality due to cancer treatment delay: Systematic review and meta-analysis. 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