After a huge drop in practice visits, elective healthcare procedures resume in some areas of the US
Friday, May 01, 2020
The following should come as no surprise to anyone whatsoever — outpatient and medical practice visits have cratered since March because of the COVID-19 pandemic. A new study showing this data comes from The Commonwealth Fund, conducted by researchers from Harvard University.
Per the study, outpatient visits dropped by 57% between March 1 and March 29. Visits were down 54% as of April 12.
Researchers looked at visit volumes for 50,000 providers. The drop is a result of providers who want to avoid transmission in their practices and patients who wish to avoid exposure.
"The COVID-19 pandemic has dramatically changed how outpatient care is delivered in health care practices," the researchers wrote.
Practices that saw the most significant drop in patient volume occurred at in-person patient facilities with specialties, such as ophthalmology, which saw declines in visits by nearly 80% as of the week of April 5. Dermatology was down 73%, and general surgery was down 66%.
Telemedicine visits increased along with the drop in in-person visits, but not enough to offset the decreases. Telemedicine use shot up recently going from almost no visits as late as March 8 to 30% of them as of April 12.
Thirty percent of ambulatory practice visits are delivered through telehealth as of mid-April.
Children between 7 and 17 and adults 75 and older were more likely to avoid such visits, researchers said.
The regions impacted varied, too, as New England saw a drop of 64% and the Mid-Atlantic as of April 12. The West Coast saw a 58% drop.
The financial pressures that accompany the drop-off in patient volumes have been enormous: As many as 20% of primary care practices could close within weeks. If the U.S. economy remains largely shuttered, the healthcare landscape is going to change dramatically across the country.
Of the physicians surveyed, nearly half of physicians said they do not know if they have enough cash to keep their practices open. Many have already laid off staff to stay afloat as the vast majority have seen the drop in visits reflected in the Harvard research.
However, states are beginning to allow the resumption of elective surgery.
The Florida Hospital Association (FHA) released a plan on April 21 for resuming elective surgeries and procedures. "Florida's hospitals remain vigilant," said FHA Interim President Crystal Stickle in a statement. "We are committed to ensuring the safety and wellbeing of our patients, employees, and communities. This has been, and will continue to be, our top priority."
Iowa Gov. Kim Reynolds announced that she’s currently rolling out plans to reopen the state. Hospitals are beginning to phase in elective surgeries and procedures next week. "Each hospital, outpatient surgery center, or clinic that determines they can safely do so may begin," Reynolds said. "They may begin rescheduling patients and resume surgeries and procedures according to their own schedules."
Ohio Department of Health Director Dr. Amy Acton issued an order recently directing providers in hospitals and outpatient medical centers to reassess procedures and surgeries that were postponed following the postponement of such activities on March 17.
Gov. Mike DeWine said: "We must now begin the gradual, multi-phased process of reopening, and my first concern is the patients who have had procedures and surgeries delayed."
The new order directs healthcare professionals to review any postponed procedures or surgeries with their patients, as well as new or other chronic conditions that may have a significant impact on a patient’s quality.
Despite states' efforts to reopen their economies, COVID-19 cases continue to rise. As of this writing, the U.S. reported more than 1 million.
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