• J Gen Intern Med · Nov 2022

    The Association of the First Surge of the COVID-19 Pandemic with the High- and Low-Value Outpatient Care Delivered to Adults in the USA.

    • David M Levine, Lipika Samal, Bridget A Neville, Elisabeth Burdick, Matthew Wien, Jorge A Rodriguez, Sandya Ganesan, Stephanie C Blitzer, Nina H Yuan, Kenney Ng, Yoonyoung Park, Amol Rajmane, Gretchen Purcell Jackson, Stuart R Lipsitz, and David W Bates.
    • Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA, USA. dmlevine@bwh.harvard.edu.
    • J Gen Intern Med. 2022 Nov 1; 37 (15): 397939883979-3988.

    BackgroundThe first surge of the COVID-19 pandemic entirely altered healthcare delivery. Whether this also altered the receipt of high- and low-value care is unknown.ObjectiveTo test the association between the April through June 2020 surge of COVID-19 and various high- and low-value care measures to determine how the delivery of care changed.DesignDifference in differences analysis, examining the difference in quality measures between the April through June 2020 surge quarter and the January through March 2020 quarter with the same 2 quarters' difference the year prior.ParticipantsAdults in the MarketScan® Commercial Database and Medicare Supplemental Database.Main MeasuresFifteen low-value and 16 high-value quality measures aggregated into 8 clinical quality composites (4 of these low-value).Key ResultsWe analyzed 9,352,569 adults. Mean age was 44 years (SD, 15.03), 52% were female, and 75% were employed. Receipt of nearly every type of low-value care decreased during the surge. For example, low-value cancer screening decreased 0.86% (95% CI, -1.03 to -0.69). Use of opioid medications for back and neck pain (DiD +0.94 [95% CI, +0.82 to +1.07]) and use of opioid medications for headache (DiD +0.38 [95% CI, 0.07 to 0.69]) were the only two measures to increase. Nearly all high-value care measures also decreased. For example, high-value diabetes care decreased 9.75% (95% CI, -10.79 to -8.71).ConclusionsThe first COVID-19 surge was associated with receipt of less low-value care and substantially less high-value care for most measures, with the notable exception of increases in low-value opioid use.© 2022. The Author(s), under exclusive licence to Society of General Internal Medicine.

      Pubmed     Free full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…