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1.
American Journal of Gastroenterology ; 117(10 Supplement 2):S1074-S1075, 2022.
Article in English | EMBASE | ID: covidwho-2324086

ABSTRACT

Introduction: As the U.S. population ages, gastroenterologists will provide care for an increasing number of older patients - many of whom use Medicare. In recent years there have been significant policy changes surrounding Medicare reimbursement for physicians. Understanding reimbursement trends can help reveal the financial impact of these policies on gastroenterologists. Our study aims to analyze the trends in Medicare reimbursement of common gastrointestinal (GI) services from 2007 to 2022. Method(s): The top 10 GI procedures and their respective CPT codes were identified through a joint list published by the American College of Gastroenterology, American Society of Gastrointestinal Endoscopy, and American Gastroenterological Association. The top 5 5 CPT codes relating to office/inpatient visits provided by gastroenterologists to Medicare Part B beneficiaries was identified using data from CMS. The Physician Fee Schedule Look-Up Tool from CMS was queried for the selected CPT codes from 2007 to 2022, to determine the facility reimbursement rate by Medicare for each service. The reimbursement data were adjusted to January 2022 U.S. dollars using the U.S. Department of Labor's Bureau of Labor Statistics' consumer price index inflation calculator. Result(s): The unadjusted physician reimbursement for GI procedures exhibited an average decrease of 7.0% (95% CI, 29.9% to 24.1%) from 2007 to 2022. After adjusting for inflation, the mean decrease in physician reimbursement for procedures was 33.0% (95% CI, 235.1% to 230.9%). The mean annual growth rate in reimbursement was 22.6% (95% CI, 22.8% to 22.4%). The unadjusted physician reimbursement for inpatient and outpatient visits exhibited an average increase of 32.1% (95% CI, 4.8% to 59.3%). After adjusting for inflation, physician reimbursement for patient visits exhibited a mean decrease of 4.92% (Figure 1). Conclusion(s): The analysis revealed a steady decline in adjusted and non-adjusted reimbursement between 2007 and 2022. Decreasing Medicare reimbursement may impact health outcomes, healthcare access, and patient satisfaction. Reimbursement policies must be scrutinized particularly in the light of high inflation and increased costs due to additional costs associated with care during the COVID-19 pandemic, staffing shortages, and increased staffing salaries. (Figure Presented).

3.
Journal of Pediatric Gastroenterology and Nutrition ; 75(Supplement 1):S117-S118, 2022.
Article in English | EMBASE | ID: covidwho-2057997

ABSTRACT

Purpose: The COVID-19 pandemic has the potential to influence the well-being of families and children with Functional Abdominal Pain Disorders (FAPDs). Given the known relationship between stress and abdominal pain in children with FAPDs, we hypothesized pandemic-related changes (e.g., reductions in family finances, social interactions) could affect health outcomes. Our aim was to examine the potential impact of the pandemic on abdominal pain, quality of life, psychological and physiological symptoms, and functional disability in children with FAPDs. Method(s): Ninety-one parents of children ages 7-12 who met the Rome IV criteria for a FAPD completed baseline questionnaires as part of an ongoing randomized controlled intervention trial on their child's Quality of life (PedsQL), Pain Behavior and Response (PBQ, PBCL, PRI), Pain Catastrophizing (PCS), Psychological Symptoms (SCL-90), Functional Disability (FDI), and sleep habits (CSHQ). Heart rate was also measured. Participants were categorized into two groups, based on the date of entry into the original study, as before or during the COVID-19 pandemic, allowing us to take advantage of a naturally occurring opportunity to assess potential impacts of the pandemic. Result(s): Sixty-one participants were consented before, and 30 participants were consented during the COVID-19 pandemic. Parents in the latter group reported their children to have more days of abdominal pain, higher pain frequency, pain behavior, disability, helplessness, and depression, and significantly lower quality of life, compared to the before COVID group (Table 1). Finally, child sleep anxiety and overall sleep difficulty were significantly higher during COVID. Children also had a significantly higher mean heart rate during the COVID-19 pandemic. Conclusion(s): Our findings suggest that the COVID-19 pandemic has impacted children with FAPDs in multiple domains. Of concern, parents of children with FAPDs reported greater child pain frequency, disability, and pain behaviors during the pandemic than before the pandemic. Parents also reported significant increased child emotional distress during the COVID-19 pandemic and impacts on quality of life during COVID-19;in fact, most scores on the PedsQL were lower than those previously reported for children receiving cancer treatment. Child sleep anxiety and overall disordered sleep also worsened during the pandemic. Additionally, physiological changes (mean heart rate) were observed during the pandemic (Figure 1). Possible explanations for these findings could include increases in child and family stress, and greater parental awareness of child symptoms due to increased time at home together, or parents' own increased stress levels. Clinicians and researchers should be aware of the potential impact of COVID-19 pandemic on these areas to inform research as well as treatment of children with FAPDs.

4.
Gastroenterology ; 162(7):S-57-S-58, 2022.
Article in English | EMBASE | ID: covidwho-1967238

ABSTRACT

Purpose: The COVID-19 pandemic has the potential to influence the well-being of families and children with Functional Abdominal Pain Disorders (FAPDs). Given the known relationship between stress and abdominal pain in children with FAPDs, we hypothesized pandemicrelated changes (e.g., reductions in family finances, social interactions) could affect health outcomes. Our aim was to examine the potential impact of the pandemic on abdominal pain, quality of life, psychological and physiological symptoms, and functional disability in children with FAPDs. Methods: Ninety-one parents of children ages 7-12 who met the Rome IV criteria for a FAPD completed baseline questionnaires as part of an ongoing randomized controlled intervention trial on their child's Quality of life (PedsQL), Pain Behavior and Response (PBQ, PBCL, PRI), Pain Catastrophizing (PCS), Psychological Symptoms (SCL-90), Functional Disability (FDI), and sleep habits (CSHQ). Heart rate was also measured. Participants were categorized into two groups, based on the date of entry into the original study, as before or during the COVID-19 pandemic, allowing us to take advantage of a naturally occurring opportunity to assess potential impacts of the pandemic. Results: Sixty-one participants were consented before, and 30 participants were consented during the COVID-19 pandemic. Parents in the latter group reported their children to have more days of abdominal pain, higher pain frequency, pain behavior, disability, helplessness, and depression, and significantly lower quality of life, compared to the before COVID group (Table 1). Finally, child sleep anxiety and overall sleep difficulty were significantly higher during COVID. Children also had a significantly higher mean heart rate during the COVID- 19 pandemic. Conclusions: Our findings suggest that the COVID-19 pandemic has impacted children with FAPDs in multiple domains. Of concern, parents of children with FAPDs reported greater child pain frequency, disability, and pain behaviors during the pandemic than before the pandemic. Parents also reported significant increased child emotional distress during the COVID-19 pandemic and impacts on quality of life during COVID-19;in fact, most scores on the PedsQL were lower than those previously reported for children receiving cancer treatment. Child sleep anxiety and overall disordered sleep also worsened during the pandemic. Additionally, physiological changes (mean heart rate) were observed during the pandemic (Figure 1). Possible explanations for these findings could include increases in child and family stress, and greater parental awareness of child symptoms due to increased time at home together, or parents' own increased stress levels. Clinicians and researchers should be aware of the potential impact of COVID-19 pandemic on these areas to inform research as well as treatment of children with FAPDs.(Table Presented) (Figure Presented)

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