The growing number of Covid cases caused hospital restrictions to be put in place that limited elective and non-essential care. What's next?
The year 2020 will not be easily forgotten, although many would like to wipe it from their memories. In the early days of the COVID-19 pandemic, poor understanding of SARS-CoV-2 led to overly cautious approaches by both patients and health care providers. The pandemic raged and hospitals were inundated with COVID-19 patients. Meanwhile, Centers for Medicare & Medicaid Services advised hospital restrictions on elective surgeries and non-essential dental, surgical, and medical procedures.
The virus had disproportionately affected the country, with states in the Northeast seeing a surge in the early days while the South saw few to no outbreaks. As a result, some states retracted earlier mandates and opened up health systems and clinics for non-emergency care and elective procedures by the end of May, but reimposed restrictions in late-June as new outbreaks emerged across the nation.
Back in May 2020, two months into the lockdown across several states in the U.S., an analysis conducted by Strata Decision Technology using data from 228 hospitals across 40 states found a decrease in cardiology (57%), breast health (55%), and cancer care overall (37%). The number of unique patients that visited a hospital dropped by 54.5%.
The most common inpatient services were drastically affected:
A series of articles were published by leading health policy researchers on The Commonwealth Fund’s website. They showed the trend seen in outpatient visits:
Telemedicine, which is the use of audio/video platforms for delivering medical care, saw a sharp rise in use by mid-March, peaked by mid-April, and plateaued by mid-July, but remains at 7% above the weekly visits pre-COVID.
Comparison of nearly 126 million primary care visits over two and a half years (Q1 of 2018 to Q2 of 2020) found:
Importantly, the pandemic saw a significant reduction in restrictions on telemedicine use from both private and government health care insurers. Telemedicine significantly compensated for the hospital restrictions that otherwise limited access to care.
A weekly survey disseminated since June 2020 by the Primary Care Collaborative, a non-profit organization focused on building a strong foundation for primary care, found that the mental health of both patients and the clinicians who have been delivering care has been worsening:
Pushing off elective surgeries and maintaining patients non-operatively may result in advanced diseases then needing more intense and expensive treatment. There are also implications for patients’ quality of life—pushing off a joint replacement surgery, for example could affect a person’s mobility; delaying a cataract surgery could affect vision and indirectly, a person’s independence.
Additionally, pandemic-related unemployment or income loss could have led to loss of insurance coverage and forced people to compromise on their health care needs. Experts are concerned that a delay in routine care and preventive screenings such as colonoscopies, mammograms, and biopsies will lower diagnoses of disease now, but once clinic and hospital restrictions are lifted, the number of diagnoses will surge.
As the nation continues to struggle with restricting the spread of the SARS-CoV-2 virus, it’s quite obvious that the health impact of this pandemic will be felt for a long time.
The information in this article was researched and summarized by Surabhi Dangi-Garimella, Ph.D., Principal, SDG AdvoHealth, LLC. Improving patient access is our mission and we are happy to utilize a variety of experts to carry that out.
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