Preventive Care Disruptions and Emergency Hospitalizations

Abstract

This paper studies whether interruptions to organized breast cancer screening lead to greater later use of emergency hospital care. It focuses on the first wave of COVID-19, when routine mammography was widely reduced across Europe, disrupting the usual screening pathway of early detection, follow-up testing, referral, and planned treatment. Using SHARE data from eight countries, the authors examine women aged 50 to 69, the main target group for organized screening programs. They estimate how mammography uptake affects all-cause overnight emergency hospitalization, interpreted as a broad measure of downstream strain on the health system after preventive care disruption. To address selection into screening, they use an instrumental variables strategy based on interview timing in Wave 9 interacted with cross-country differences in first-wave restrictions. The results suggest that pandemic-related declines in mammography increased later emergency hospitalization for screening-eligible women, while no such effect appears for women aged 70 and older.