The diagnostic panels and cancer screenings generally carried out during annual visits to the doctor fell by 68% at the national level, and even more in the hot spots of the coronaviruses.
These tests, office visits, surgeries, and other related medical care are key sources of revenue for hospitals and health systems that have had to limit lucrative elective procedures to make room for the overwriting of patients with COVID-19, the disease caused by the new coronavirus.
Millions of patients have postponed tests deemed crucial to detect the first signs of the disease, monitor its progression and improve patient outcomes, according to Komodo, which has one of the largest medical claims databases in the country and has provided its new findings exclusively to Reuters.
Cervical cancer screenings were down 68%, cholesterol panels fell 67% and the blood glucose test for diabetes was 65% nationally. All of this could prove to be very costly along the way.
“We are seeing a huge impact on preventive care, as well as on chronic diseases with massive implications for the health system,” said Dr. Arif Nathoo, CEO of Komodo Health. “This speaks volumes about the impact of COVID on everyone’s health and well-being. “
San Francisco-based Komodo reviewed the billing records of 320 million patients across the country from March 19 to April 20 and compared them to the previous 11 weeks and a similar period last year.
He found the biggest drop in testing and screening in areas hardest hit by the epidemic, such as Manhattan in New York, where A1c blood tests for diabetes dropped more than 90%. In Massachusetts, cholesterol tests dropped 80.5%, while in California, screening for cervical cancer before it spreads and becomes difficult to treat was 76, 3%.
“Many of these tests are performed infrequently, but they are performed when a patient visits their doctor,” said Nathoo.
Data from Komodo and others has begun to highlight gaps in care created by an epidemic that has infected nearly one million people in the United States and could have a lasting impact on the American healthcare system. beyond COVID-19.
“There are millions of patients who have delayed care. And many of these patients are chronic disease patients with all kinds of complications, “said David Linetsky, life science manager at Phreesia, a New York-based patient care technology company. “There are going to be huge health impacts. “
Linetsky co-authored an analysis with researchers from Harvard University published last week which found that office visits fell by almost 60% in mid-March and remained low until mid- April.
Dr. David Tom Cooke, chief of general thoracic surgery at UC-Davis Health, said his cancer patients are receiving treatment. But he fears that new cancers will be detected until they are more advanced and less survivable.
“We don’t do cancer screening, like mammography for breast cancer and lung cancer screening,” he said. “We are concerned that we will delay standard treatment for patients with potentially curable cancers.”
The growing backlog has created new challenges for hospitals, doctors and clinics. Some practices estimate a lockout of four to six months for each month that prevents routine visits and screening.
Business is down 75% at Family Medicine Associates in Attleboro, Massachusetts, a generally lively practice with more than 10,000 patients.
Last week, the firm closed one of the two offices and put half of the staff on leave. They hope to reopen in June or sooner if they get a loan from the Small Business Administration, said Dr. Jennifer Souza, one of eight doctors there.
The practice initially limited appointments, so no more than two patients sat in the waiting room at a time. Most recently, patients have been alone, fearing they may contract the virus. Doctors are also concerned about putting their sicker patients at risk by planning office visits.
Souza visited the home of a blind diabetic patient who had fallen on Monday, possibly due to worsening neuropathy, she said. Normally, the patient would have taken a numbering service for an A1c exam and test. “But his risk of complications is so high that I would be nervous for him to have this additional exposure,” she said.
Diagnostic screenings may not be as lucrative for hospitals and doctors as elective procedures, such as knee replacements and cataract surgeries, but they play a crucial role in detecting problems that can lead to more comprehensive care, said Mallory Caldwell, director of Ernest & Young.
The sheer volume of routine office visits and diagnostic exams also supports many medical practices, particularly in low-income communities and rural areas that were already struggling before the epidemic. Last year, 19 rural hospitals closed, the highest peak in a decade.
If patients continue to move away, healthcare policy experts fear that these hospitals and clinics may not have the financial cushion to survive.
“If these practices stop,” said Ateev Mehrotra, associate professor of health policy at Harvard Medical School, “then the access problems that already exist in these communities, and the disparity in care, could be exacerbated. “
Reports from Robin Respaut in San Francisco and Deborah J. Nelson in Maryland; Editing by Bill Berkrot
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