Journal article
Risk from delayed or missed care and non-COVID-19 outcomes for older patients with chronic conditions during the pandemic
Journal of the American Geriatrics Society (JAGS), Vol.70(5), pp.1314-1324
05/2022
DOI: 10.1111/jgs.17722
PMCID: PMC9106879
PMID: 35211958
Abstract
During the COVID-19 pandemic, patients with chronic illnesses avoided regular medical care, raising concerns about long-term complications. Our objective was to identify a population of older patients with chronic conditions who may be at risk from delayed or missed care (DMC) and follow their non-COVID outcomes during the pandemic.
We used a retrospective matched cohort design using Medicare claims and electronic health records at a large health system with community and academic clinics. Participants included 14,406 patients over 65 years old with two or more chronic conditions who had 1 year of baseline data and up to 9 months of postpandemic follow-up from March 1, 2019 to December 31, 2020; and 14,406 matched comparison patients from 1 year prior. Risk from DMC was defined by 13 indicators, including chronic conditions, frailty, disability affecting the use of telehealth, recent unplanned acute care, prior missed outpatient care, and social determinants of health. Outcomes included mortality, inpatient events, Medicare payments, and primary care and specialty care visits (in-person and telehealth).
A total of 25% of patients had four or more indicators for risk from DMC. Per 1000 patients annually, those with four or more indicators had increased mortality of 19 patients (95% confidence interval, 4 to 32) and decreased utilization, including unplanned events (-496 events, -611 to -381) and primary care visits (-1578 visits, -1793 to -1401).
Older patients who had four or more indicators for risk from DMC had higher mortality and steep declines in inpatient and outpatient utilization during the pandemic.
Details
- Title: Subtitle
- Risk from delayed or missed care and non-COVID-19 outcomes for older patients with chronic conditions during the pandemic
- Creators
- Maureen Smith - University of Wisconsin–MadisonMary Vaughan Sarrazin - University of IowaXinyi Wang - University of Wisconsin–MadisonPeter Nordby - University of Wisconsin–MadisonMenggang Yu - University of Wisconsin–MadisonAllie J DeLonay - University of Wisconsin–MadisonJonathan Jaffery - University of Wisconsin–Madison
- Resource Type
- Journal article
- Publication Details
- Journal of the American Geriatrics Society (JAGS), Vol.70(5), pp.1314-1324
- DOI
- 10.1111/jgs.17722
- PMID
- 35211958
- PMCID
- PMC9106879
- ISSN
- 0002-8614
- eISSN
- 1532-5415
- Grant note
- HSD-1603-35039 / Patient-Centered Outcomes Research Institute 9 U54 TR000021 / NCATS NIH HHS University of Wisconsin School of Medicine and Public Health's Health Innovation Program (HIP) UL1 RR025011 / NCRR NIH HHS the Wisconsin Partnership Program
- Language
- English
- Date published
- 05/2022
- Academic Unit
- Health Management and Policy; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984360147602771
Metrics
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