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新冠疫情对美国门诊医生的影响。

Effects of the COVID-19 Pandemic on Outpatient Providers in the United States.

机构信息

Department of Economics, The University at Albany, Albany, NY.

出版信息

Med Care. 2021 Jan;59(1):58-61. doi: 10.1097/MLR.0000000000001448.

Abstract

BACKGROUND

During the COVID-19 pandemic, there is concern that social distancing, fear of contagion, quarantining of providers, cancellation of elective procedures, media coverage about the pandemic, and other factors drastically reduced physician visits, putting severe financial strain on outpatient providers, and having unknown ramifications for health outcomes.

OBJECTIVES

We estimate the effect of the pandemic on utilization of outpatient services.

RESEARCH DESIGN

Using 2010-2020 data from a national dataset, the Outpatient Influenza-like Illness Surveillance Network, we estimate the difference in outpatient care utilization during the time period of the COVID-19 pandemic versus the same weeks in prior years.

RESULTS

Our findings indicate that the pandemic started to reduce visits during the week of March 15-21. The effect on visits grew until reaching a peak during the week of April 5-11, 2020, when the pandemic reduced the total number of outpatient visits per provider by 70% relative to the same week in prior years. We find negative effects of the pandemic on visits for non-flu symptoms as well as on visits for flu symptoms, but the magnitudes of these latter effects tended to be larger in magnitude. The pandemic's impact declined over time, and by the week of June 28 to July 4, 2020, there was no longer any difference in total visits per provider relative to the same week in prior years. Despite the resurgence of COVID-19 in June and July, we still find no effects on total visits when our data end in July 26 to August 1, 2020.

CONCLUSIONS

Our findings show that one by-product of the COVID-19 pandemic in the United States is a large decline in the use of outpatient care which peaked around the week of April 5-11. Total outpatient visits rebounded completely and remain stable as of July 26 to August 1, 2020.

摘要

背景

在 COVID-19 大流行期间,人们担心社交距离、对传染的恐惧、医护人员隔离、择期手术取消、有关大流行的媒体报道以及其他因素会大幅减少医生就诊次数,给门诊提供者带来严重的财务压力,并对健康结果产生未知影响。

目的

我们估计大流行对门诊服务利用的影响。

研究设计

利用来自全国性数据集——门诊流感样疾病监测网络的 2010-2020 年数据,我们估计了 COVID-19 大流行期间与前几年同期相比,门诊护理利用情况的差异。

结果

我们的研究结果表明,大流行从 3 月 15 日至 21 日开始减少就诊次数。这种影响持续增长,直到 2020 年 4 月 5 日至 11 日达到高峰,当时大流行使每位医生的门诊就诊人次相对前几年同期减少了 70%。我们发现大流行对非流感症状就诊和流感症状就诊都有负面影响,但后者的影响幅度往往更大。大流行的影响随着时间的推移而下降,到 2020 年 6 月 28 日至 7 月 4 日,相对于前几年同期,每位医生的就诊总人次已无差异。尽管 COVID-19 在 6 月和 7 月再次出现,但是当我们的数据截止到 2020 年 7 月 26 日至 8 月 1 日时,就诊总人次仍未发现有任何影响。

结论

我们的研究结果表明,美国 COVID-19 大流行的一个附带后果是,门诊护理的使用大幅下降,在 4 月 5 日至 11 日这一周达到峰值。截至 2020 年 7 月 26 日至 8 月 1 日,门诊就诊总人次已完全反弹且保持稳定。

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