The Impact of Public Discourse on Healthcare Utilization during the COVID-19 Pandemic

(Project funded by DFG/German Research Foundation, June 2021 - July 2023; in collaboration with Prof. Dr. Jonas Schreyögg, Dr. Esra Bayindir, Hamburg Center for Health Economics)

The aim of this project is a comparative analysis of public discourses around the COVID-19 pandemic across time and two countries (Germany and England) that adopted distinct public policy responses. Through the use of several complementing analytical tools and data sources, the analysis will reveal which variables affected the public response to health policy measures adopted in the face of the pandemic and utilization of health care services unrelated to COVID- 19. Against the background of the unintended and long-lasting public health consequences associated with the COVID-19 pandemic, our project will provide essential lessons for public policy actors on how public policies are perceived by the population and to what extent they comply or respond to them. England and Germany provide an instructive test case for this approach for several reasons. Both countries share considerable demographic, social, economic and cultural similarities, but England fared considerably worse during the pandemic both in terms of morbidity and mortality.

This project will track public debates through a big data approach, based on newspaper and social media data. We will identify a range of keywords associated with the debate around COVID-19 (e.g., for German, Corona, Coronalüge, Lockdown). Based on these keywords, we will compile a large database of newspapers reports and geotagged social media data. This database will then be analyzed as to the frequency of the debate, non-literal language as well as sentiments expressed during the debate. We will focus on the period of time between December 2019 (i.e. before the onset of the pandemic in England and Germany) until end of the pandemic, or three months before the end of the project period, whichever comes first. Using this data, we will estimate the causal impact of intensity of the debate, sentiments and metaphors associated with it, on actual uptake of public policies and utilization of health care services unrelated to COVID-19 by county/Landkreis across time. Public response to health policy measures and utilization of emergency departments, ambulatory care services for preventive care will be tracked based on patient level data; claims data of statutory health insurance funds for Germany and data from the National Health Service for England.

We will employ state of the art techniques to estimate the impact of public discourse as well as policy measures taken to mitigate the pandemic, socioeconomic factors and political orientation on health care utilization and adherence to social distancing. Quantifying the effects of public discourse, policy measures, socioeconomic factors and political orientation on health care utilization and adherence to social distancing will be critical for policy makers to determine the target areas to mitigate pandemics.