Shifts in ophthalmic care utilization during the COVID-19 pandemic in the US
© 2023. The Author(s)..
BACKGROUND: Healthcare restrictions during the COVID-19 pandemic, particularly in ophthalmology, led to a differential underutilization of care. An analytic approach is needed to characterize pandemic health services usage across many conditions.
METHODS: A common analytical framework identified pandemic care utilization patterns across 261 ophthalmic diagnoses. Using a United States eye care registry, predictions of utilization expected without the pandemic were established for each diagnosis via models trained on pre-pandemic data. Pandemic effects on utilization were estimated by calculating deviations between observed and expected patient volumes from January 2020 to December 2021, with two sub-periods of focus: the hiatus (March-May 2020) and post-hiatus (June 2020-December 2021). Deviation patterns were analyzed using cluster analyses, data visualizations, and hypothesis testing.
RESULTS: Records from 44.62 million patients and 2455 practices show lasting reductions in ophthalmic care utilization, including visits for leading causes of visual impairment (age-related macular degeneration, diabetic retinopathy, cataract, glaucoma). Mean deviations among all diagnoses are 67% below expectation during the hiatus peak, and 13% post-hiatus. Less severe conditions experience greater utilization reductions, with heterogeneities across diagnosis categories and pandemic phases. Intense post-hiatus reductions occur among non-vision-threatening conditions or asymptomatic precursors of vision-threatening diseases. Many conditions with above-average post-hiatus utilization pose a risk for irreversible morbidity, such as emergent pediatric, retinal, or uveitic diseases.
CONCLUSIONS: We derive high-resolution insights on pandemic care utilization in the US from high-dimensional data using an analytical framework that can be applied to study healthcare disruptions in other settings and inform efforts to pinpoint unmet clinical needs.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:3 |
|---|---|
| Enthalten in: |
Communications medicine - 3(2023), 1 vom: 14. Dez., Seite 181 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Li, Charles [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Revised 17.12.2023 published: Electronic Citation Status PubMed-not-MEDLINE |
|---|
| doi: |
10.1038/s43856-023-00416-4 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM365885029 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM365885029 | ||
| 003 | DE-627 | ||
| 005 | 20231227133605.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231227s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1038/s43856-023-00416-4 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1230.xml |
| 035 | |a (DE-627)NLM365885029 | ||
| 035 | |a (NLM)38097811 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Li, Charles |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Shifts in ophthalmic care utilization during the COVID-19 pandemic in the US |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 17.12.2023 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2023. The Author(s). | ||
| 520 | |a BACKGROUND: Healthcare restrictions during the COVID-19 pandemic, particularly in ophthalmology, led to a differential underutilization of care. An analytic approach is needed to characterize pandemic health services usage across many conditions | ||
| 520 | |a METHODS: A common analytical framework identified pandemic care utilization patterns across 261 ophthalmic diagnoses. Using a United States eye care registry, predictions of utilization expected without the pandemic were established for each diagnosis via models trained on pre-pandemic data. Pandemic effects on utilization were estimated by calculating deviations between observed and expected patient volumes from January 2020 to December 2021, with two sub-periods of focus: the hiatus (March-May 2020) and post-hiatus (June 2020-December 2021). Deviation patterns were analyzed using cluster analyses, data visualizations, and hypothesis testing | ||
| 520 | |a RESULTS: Records from 44.62 million patients and 2455 practices show lasting reductions in ophthalmic care utilization, including visits for leading causes of visual impairment (age-related macular degeneration, diabetic retinopathy, cataract, glaucoma). Mean deviations among all diagnoses are 67% below expectation during the hiatus peak, and 13% post-hiatus. Less severe conditions experience greater utilization reductions, with heterogeneities across diagnosis categories and pandemic phases. Intense post-hiatus reductions occur among non-vision-threatening conditions or asymptomatic precursors of vision-threatening diseases. Many conditions with above-average post-hiatus utilization pose a risk for irreversible morbidity, such as emergent pediatric, retinal, or uveitic diseases | ||
| 520 | |a CONCLUSIONS: We derive high-resolution insights on pandemic care utilization in the US from high-dimensional data using an analytical framework that can be applied to study healthcare disruptions in other settings and inform efforts to pinpoint unmet clinical needs | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Lum, Flora |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Evan M |e verfasserin |4 aut | |
| 700 | 1 | |a Collender, Philip A |e verfasserin |4 aut | |
| 700 | 1 | |a Head, Jennifer R |e verfasserin |4 aut | |
| 700 | 1 | |a Khurana, Rahul N |e verfasserin |4 aut | |
| 700 | 1 | |a Cunningham, Emmett T |c Jr |e verfasserin |4 aut | |
| 700 | 1 | |a Moorthy, Ramana S |e verfasserin |4 aut | |
| 700 | 1 | |a Parke, David W |c 2nd |e verfasserin |4 aut | |
| 700 | 1 | |a McLeod, Stephen D |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Communications medicine |d 2021 |g 3(2023), 1 vom: 14. Dez., Seite 181 |w (DE-627)NLM330650033 |x 2730-664X |7 nnns |
| 773 | 1 | 8 | |g volume:3 |g year:2023 |g number:1 |g day:14 |g month:12 |g pages:181 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1038/s43856-023-00416-4 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 3 |j 2023 |e 1 |b 14 |c 12 |h 181 | ||