The Impact of the COVID-19 Pandemic on Health Care Utilization Among Insured Individuals With Common Chronic Conditions

ABSTRACT

Objective: The COVID pandemic has had a significant impact on the US health care system. Our primary objective was to understand the impact of the COVID pandemic on non-COVID-related health care utilization among insured individuals with chronic conditions. Our secondary objective was to examine the differential impact by individual characteristics. Main Data Source Medical and pharmacy claims data for individuals enrolled in a large insurer across the United States. Research Design: A retrospective and repeated cross-sectional study. Overall and condition-specific health care utilization and cost metrics in (1) March 1 to June 15 and (2) June 16 to September 30, 2020 were compared with the same months during 2016-2019. Subjects: Members of all ages with a diagnosis of diabetes, cardiovascular disease, or chronic kidney disease with commercial or Medicare Advantage insurance. Results: Most non-COVID-related health care utilization decreased drastically on March 1 to June 15, 2020 [odds ratio (OR) range across condition-specific tests 0.55-0.69;incidence rate ratio (IRR) range for hospitalization/emergency department (ED) visit/outpatient visit 0.65-0.77] but returned to closer to pre-COVID levels by June 16 to September 30, 2020 [OR range across condition-specific tests 0.93-1.08;IRR range for hospitalization/ED visit/outpatient visit 0.77-0.97]. Our study found an enormous increase in telehealth use on March 1 to June 15, 2020 (90-170 times prepandemic levels). A differential impact was observed by age, sex, region of residence, and insurance type. Implications Further investigation is needed to assess the impact of these changes in health care utilization on long-term health outcomes.