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Impact of the COVID-19 Pandemic on Urological Care Delivery in the United States.
Lee, Daniel J; Shelton, Jeremy B; Brendel, Paul; Doraiswami, Rahul; Makarov, Danil; Meeks, William; Fang, Raymond; Roe, Matthew T; Cooperberg, Matthew R.
  • Lee DJ; Division of Urology, Department of Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania.
  • Shelton JB; Department of Urology, University of California Los Angeles, Los Angeles, California.
  • Brendel P; Verana Health, San Francisco, California.
  • Doraiswami R; Verana Health, San Francisco, California.
  • Makarov D; VA New York Harbor Healthcare System and Departments of Urology and Population Health, New York University Langone Medical Center, New York, New York.
  • Meeks W; American Urological Association Education & Research, Department of Data Management & Statistical Analysis, Linthicum, Maryland.
  • Fang R; American Urological Association Education & Research, Department of Data Management & Statistical Analysis, Linthicum, Maryland.
  • Roe MT; Verana Health, San Francisco, California.
  • Cooperberg MR; Departments of Urology, and Epidemiology and Biostatistics, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California.
J Urol ; 206(6): 1469-1479, 2021 12.
Article in English | MEDLINE | ID: covidwho-1410198
ABSTRACT

PURPOSE:

We examined changes in urological care delivery due to COVID-19 in the U.S. based on patient, practice, and local/regional demographic and pandemic response features. MATERIALS AND

METHODS:

We analyzed real-world data from the American Urological Association Quality (AQUA) Registry collected from electronic health record systems. Data represented 157 outpatient urological practices and 3,165 providers across 48 U.S. states and territories, including 3,297,721 unique patients, 12,488,831 total outpatient visits and 2,194,456 procedures. The primary outcome measure was the number of outpatient visits and procedures performed (inpatient or outpatient) per practice per week, measured from January 2019 to February 2021.

RESULTS:

We found large (>50%) declines in outpatient visits from March 2020 to April 2020 across patient demographic groups and states, regardless of timing of state stay-at-home orders. Nonurgent outpatient visits decreased more across various nonurgent procedures (49%-59%) than for procedures performed for potentially urgent diagnoses (38%-52%); surgical procedures for nonurgent conditions also decreased more (43%-79%) than those for potentially urgent conditions (43%-53%). African American patients had similar decreases in outpatient visits compared with Asians and Caucasians, but also slower recoveries back to baseline. Medicare-insured patients had the steepest declines (55%), while those on Medicaid and government insurance had the lowest percentage of recovery to baseline (73% and 69%, respectively).

CONCLUSIONS:

This study provides real-world evidence on the decline in urological care across demographic groups and practice settings, and demonstrates a differential impact on the utilization of urological health services by demographics and procedure type.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Urologic Diseases / Urology / Communicable Disease Control / Pandemics / COVID-19 Type of study: Prognostic study / Randomized controlled trials Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: North America Language: English Journal: J Urol Year: 2021 Document Type: Article

Full text: Available Collection: International databases Database: MEDLINE Main subject: Urologic Diseases / Urology / Communicable Disease Control / Pandemics / COVID-19 Type of study: Prognostic study / Randomized controlled trials Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: North America Language: English Journal: J Urol Year: 2021 Document Type: Article