Anthem Inc., Indianapolis, IN.
Department of Healthcare Administration and Policy, University of Nevada, Las Vegas, NV.
Med Care. 2022 Sep 1;60(9):673-679. doi: 10.1097/MLR.0000000000001747. Epub 2022 Jul 22.
The COVID pandemic has had a significant impact on the US health care system. Our primary objective was to understand the impact of the COVID pandemic on non-COVID-related health care utilization among insured individuals with chronic conditions. Our secondary objective was to examine the differential impact by individual characteristics.
Medical and pharmacy claims data for individuals enrolled in a large insurer across the United States.
A retrospective and repeated cross-sectional study. Overall and condition-specific health care utilization and cost metrics in (1) March 1 to June 15 and (2) June 16 to September 30, 2020 were compared with the same months during 2016-2019.
Members of all ages with a diagnosis of diabetes, cardiovascular disease, or chronic kidney disease with commercial or Medicare Advantage insurance.
Most non-COVID-related health care utilization decreased drastically on March 1 to June 15, 2020 [odds ratio (OR) range across condition-specific tests: 0.55-0.69; incidence rate ratio (IRR) range for hospitalization/emergency department (ED) visit/outpatient visit: 0.65-0.77] but returned to closer to pre-COVID levels by June 16 to September 30, 2020 [OR range across condition-specific tests: 0.93-1.08; IRR range for hospitalization/ED visit/outpatient visit: 0.77-0.97]. Our study found an enormous increase in telehealth use on March 1 to June 15, 2020 (90-170 times prepandemic levels). A differential impact was observed by age, sex, region of residence, and insurance type.
Further investigation is needed to assess the impact of these changes in health care utilization on long-term health outcomes.
新冠疫情对美国医疗体系产生了重大影响。我们的主要目标是了解新冠疫情对有慢性病的参保人群中非新冠相关医疗保健利用的影响。我们的次要目标是研究个体特征的差异影响。
美国一家大型保险公司参保人员的医疗和药品理赔数据。
回顾性和重复的横断面研究。在 2020 年 3 月 1 日至 6 月 15 日和 2020 年 6 月 16 日至 9 月 30 日期间，与 2016-2019 年同期相比，总体和特定疾病的医疗保健利用和费用指标进行了比较。
有糖尿病、心血管疾病或慢性肾脏病诊断，且有商业保险或医疗保险优势计划的所有年龄段的参保人员。
2020 年 3 月 1 日至 6 月 15 日，大多数非新冠相关医疗保健利用急剧下降（特定疾病测试的比值比范围：0.55-0.69；住院/急诊就诊/门诊就诊的发病率比范围：0.65-0.77），但到 2020 年 6 月 16 日至 9 月 30 日，又恢复到接近新冠疫情前的水平（特定疾病测试的比值比范围：0.93-1.08；住院/急诊就诊/门诊就诊的发病率比范围：0.77-0.97）。我们的研究发现，2020 年 3 月 1 日至 6 月 15 日期间，远程医疗的使用量大幅增加（是大流行前水平的 90-170 倍）。按年龄、性别、居住地区和保险类型观察到差异影响。
需要进一步调查，以评估医疗保健利用的这些变化对长期健康结果的影响。
