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预防保健服务中断:COVID-19 大流行期间的乳房 X 光检查。

Disruptions in preventive care: Mammograms during the COVID-19 pandemic.

机构信息

Operations, Information and Decisions Department, The Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

出版信息

Health Serv Res. 2021 Feb;56(1):95-101. doi: 10.1111/1475-6773.13596. Epub 2020 Nov 4.

Abstract

OBJECTIVE

To measure the extent to which the provision of mammograms was impacted by the COVID-19 pandemic and surrounding guidelines.

DATA SOURCES

De-identified summary data derived from medical claims and eligibility files were provided by Independence Blue Cross for women receiving mammograms.

STUDY DESIGN

We used a difference-in-differences approach to characterize the change in mammograms performed over time and a queueing formula to estimate the time to clear the queue of missed mammograms.

DATA COLLECTION

We used data from the first 30 weeks of each year from 2018 to 2020.

PRINCIPAL FINDINGS

Over the 20 weeks following March 11, 2020, the volume of screening mammograms and diagnostic mammograms fell by 58% and 38% of expected levels, on average. Lowest volumes were observed in week 15 (April 8 to 14), when screening and diagnostic mammograms fell by 99% and 74%, respectively. Volumes began to rebound in week 19 (May), with diagnostic mammograms reaching levels to similar to previous years' and screening mammograms remaining 14% below expectations. We estimate it will take a minimum of 22 weeks to clear the queue of missed mammograms in our study sample.

CONCLUSIONS

The provision of mammograms has been significantly disrupted due to the COVID-19 pandemic.

摘要

目的

衡量 COVID-19 大流行及其相关指南对乳房 X 光检查实施的影响程度。

资料来源

独立蓝十字公司为接受乳房 X 光检查的女性提供了从医疗索赔和资格档案中提取的去标识汇总数据。

研究设计

我们使用差异中的差异方法来描述随时间推移进行乳房 X 光检查的变化,并使用排队公式来估计清除错过的乳房 X 光检查队列所需的时间。

资料收集

我们使用了 2018 年至 2020 年每年的前 30 周的数据。

主要发现

在 2020 年 3 月 11 日之后的 20 周内,平均而言,筛查性乳房 X 光检查和诊断性乳房 X 光检查的数量分别下降了 58%和 38%。在第 15 周(4 月 8 日至 14 日)观察到最低的数量,此时筛查性和诊断性乳房 X 光检查分别下降了 99%和 74%。数量在第 19 周(5 月)开始反弹,诊断性乳房 X 光检查的数量达到与前几年相似的水平,而筛查性乳房 X 光检查仍低于预期的 14%。我们估计,在我们的研究样本中,清除错过的乳房 X 光检查队列至少需要 22 周的时间。

结论

由于 COVID-19 大流行,乳房 X 光检查的实施受到了严重干扰。

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