ABSTRACT
The COVID-pandemic has abruptly impacted health care systems. Using data from Medicare claims we examined the pandemic-related changes in health care utilization among fee-for-service beneficiaries with diabetes. We included persons with diabetes who were aged ≥ 67 and enrolled in both Part A and B programs for all months of the index year and the previous year. Diabetes was identified by having at least one inpatient or two outpatient claims that were diabetes related. We considered utilization by setting (acute inpatient, emergency room, hospital outpatient [HOP], physician office, and ambulatory surgery center [ASC] procedures) and by media (telehealth and in-person) . Utilization was measured as per person use of each type of health care service for each month from Jan. 2018 to Jun. 2021. We quantified the changes in utilization with a fixed-effect model for all post-pandemic months (3/2020-6/2021) and three phases (3/2020-5/2020;6/2020-12/2020;and 1/2021-6/2021) . We found that health care services usage by setting was 8% to 18% lower than the pre-pandemic level (Table) . Phase 1 had the largest decrease in utilization. In phase 3, utilization was still lower than the pre-pandemic level for most service types, except HOP visits and ASC procedures. We also found a large increase in telehealth visits, although the increase was not large enough to compensate for the decrease in in-person office visits.