Public Health

Why 41% of patients have skipped care during COVID-19 pandemic

Tanya Albert Henry , Contributing News Writer

That empty office waiting room you saw for months on end last year was not the exception to the rule, according to recently published research. More than 40% of people surveyed said they skipped medical care in the early months of the pandemic.

What doctors wish patients knew

Keep patients up-to-date on how to safely navigate the pandemic with insights from physician colleagues in this special edition of AMA Moving Medicine.

Here’s why:

  • 63% said a medical practice was closed temporarily or permanently.
  • 57% feared COVID-19 exposure.
  • 7% blamed financial repercussions of the pandemic.

The study, recently published online in JAMA Network Open, “Reports of Forgone Medical Care Among US Adults During the Initial Phase of the COVID-19 Pandemic,” also quantified what kind of care patients missed.

Researchers examining the period between March and mid-July 2020 found that, among the 1,337 respondents:

  • 29% missed a preventive care visit.
  • 26% missed an outpatient general medical appointment.
  • 8% missed one or more doses of a prescription medicine typically picked up from a retail pharmacy.
  • 8% missed an outpatient mental health appointment.
  • 6% missed an elective surgery.
  • 3% did not receive health care for a new severe mental or physical health issue.

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When researchers looked at data from those who reported needing care during those initial months of the pandemic, the percentages forgoing health care were even higher. Among this group, 52% reported skipping care.

More specifically:

  • 60% with a scheduled elective surgical procedure missed it.
  • 58% missed scheduled preventative care.
  • 51% with a severe mental or physical health issue that emerged after the start of the pandemic forwent care.
  • 50% missed general medical care.
  • 46% with scheduled mental health care reported missing visits.
  • 15% didn’t pick up a prescription and missed one or more doses.

“Physicians can mitigate some of the long-term harmful effects of this forgone care by proactively reaching out to patients who missed care to try and reschedule the care either in-person or through telehealth,” said the study’s corresponding author, Kelly E. Anderson, MPP, a PhD candidate in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health.

An AMA survey about the COVID-19 pandemic’s impact provides a window into the financial pressures physician practices have faced and continue to experience, including a 32% drop in revenue since February. The survey was conducted online from mid-July through the end of August.

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Preventing future missed care

As the pandemic continues, researchers offered some suggestions on how to help prevent patients from missing health care appointments, prescription medication or other health care.

For example, continuing to provide financial and regulatory support for telehealth is one way to help patients continue to receive care as they continue to be worried about being exposed to COVID-19, the authors wrote. Find out how the AMA is advancing telemedicine during the pandemic.

Researchers noted that many patients have been able to access care because states and the federal government temporarily loosened licensing, electronic prescribing and written consent laws and many payers have temporarily increased the types of services that can be delivered via telehealth and they have been paying for visits they previously would not have covered.

Making sure patients have insurance coverage is also important.

“Actions such as the recent executive order to reopen the enrollment period for the federal health exchanges can help individuals who have lost employer coverage to regain insurance,” Anderson said. “Other financial support for individuals financially affected by the COVID-19 pandemic, such as extended unemployment insurance, can also reduce the extent of forgone care due to financial concerns.”

Stay up to speed on the AMA’s COVID-19 advocacy efforts and track the fast-moving pandemic with the AMA's COVID-19 resource center, which offers a library of the most up-to-date resources from JAMA Network™, the Centers for Disease Control and Prevention, and the World Health Organization.