Utilisation of rehabilitation due to mental disorders during the SARS-CoV-2 pandemic: a difference-in-differences analysis

BACKGROUND: Our analyses examined the extent to which the use of rehabilitation for patients with mental disorders decreased due to the COVID-19 pandemic in Germany. METHODS: We used monthly cross-sectional administrative data on rehabilitation utilisation due to mental disorders in 2019 and 2020 and estimated a difference-in-differences model to determine the reduction in rehabilitation utilisation attributable to the pandemic. RESULTS: We included 151,775 rehabilitations in 2019 and 123,229 rehabilitations in 2020 in our analysis. The number of rehabilitations decreased from April to December by 14.2% due to the pandemic (March to December: 21.8%). The decline was more pronounced for women than for men and varied regionally. Temporal and regional differences in utilisation were moderately associated with the decrease in mobility in the pandemic year. In the first phase of the pandemic, i.e., March and April 2020, the decline was strongly associated with the regional incidence of SARS-CoV-2 infection. CONCLUSION: Due to the pandemic, significantly fewer rehabilitations due to mental disorders occurred in Germany in 2020 than in 2019. The likely increasing need for rehabilitation for people with mental disorders should be addressed by making rehabilitation access and delivery more flexible.