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RESEARCHERS EXAMINE FOREGONE MEDICAL CARE AMONG MEDICARE BENEFICIARIES DURING
PANDEMIC

Analysis  |  By Christopher Cheney  
|   January 10, 2022


TOPICS

COVID-19
research


PHYSICIAN-DRIVEN FACTORS SUCH AS CLOSED PHYSICIAN OFFICES HAVE PLAYED A MAJOR
ROLE IN FOREGONE MEDICAL CARE FOR MEDICARE BENEFICIARIES DURING THE PANDEMIC,
STUDY FINDS.

--------------------------------------------------------------------------------


KEY TAKEAWAYS

More than 11% of Medicare beneficiaries reported forgone medical care because of
COVID-19.

Dental care was the most common care that was delayed or forgone (4.3% of survey
respondents), followed by prevention (4.0%) and checkups (3.9%).

Most Medicare beneficiaries forwent medical care due to physician-driven
factors, with the percentage of beneficiaries who forwent medical care because
of physician-driven factors dropping from 66.2% in the week of July 7, 2020, to
44.7% in the weeks of April 4 to April 25, 2021.

Forgone medical care for Medicare beneficiaries during the coronavirus pandemic
has decreased over time and forgone medical care was more pronounced among
Medicare beneficiaries who reported mental health problems, a recent study
found.



Before the pandemic, delayed or forgone medical care was a known healthcare
issue and previous research had linked it to poor health outcomes that
inequitably impacted vulnerable patients. Other previous research has showed
that about 40% of U.S. adults have reported forgone medical care during the
pandemic, with fear of COVID-19 exposure cited among the reasons.









--------------------------------------------------------------------------------


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The recent study, which was published by JAMA Health Forum, includes data
collected from more than 23,000 Medicare beneficiaries in three time periods:
June 7 to July 12, 2020, Oct. 4 to Nov. 8, 2020, and Feb. 28 to April 25, 2021.
The data was gathered from the Medicare Current Beneficiary Survey COVID-19
Supplement Public Use File.



The recent study features several key data points.



 * 11.5% of Medicare beneficiaries reported forgone medical care because of
   COVID-19
    
 * Dental care was the most common care that was delayed or forgone (4.3% of
   survey respondents), followed by prevention (4.0%) and checkups (3.9%)
    
 * Rates of forgone medical care decreased in all three of the periods examined
   in the recent study, with the largest decrease found between June 7 and July
   12, 2020 (22.4% to 15.9%)
    
 * Most Medicare beneficiaries forwent medical care due to physician-driven
   factors, with the percentage of beneficiaries who forwent medical care
   because of physician-driven factors dropping from 66.2% in the week of July
   7, 2020, to 44.7% in the weeks of April 4 to April 25, 2021
    
 * From June 7 to July 12, 2020, the most common reported physician barrier was
   that the physician's office was closed
    
 * From April 4 to April 25, 2021, the most common reported physician barrier
   was that the physician had reduced appointments
    
 * The most common reported patient factor for foregoing care was that the
   patient felt risk of COVID-19 exposure and wanted to stay home
    
 * Medicare beneficiaries who reported feeling more stressed or anxious than
   those who did not had a likelihood of foregoing medical care 4 percentage
   points higher
    
 * Medicare beneficiaries who reported feeling more lonely or sad than those who
   did not had a likelihood of foregoing medical care 3 percentage points higher
    
 * Medicare beneficiaries who reported feeling less socially connected than
   those who did not had a likelihood of foregoing medical care 3 percentage
   points higher

"The results of this cross-sectional survey study suggest that public health
emergencies, such as pandemics, may exacerbate existing barriers to care and
cause patients to delay needed care. Factors unique to the pandemic included
closed physician’s offices, reduced appointment availability, and patient fear
of contagion. Medicare beneficiaries who are experiencing heightened mental
health problems associated with the COVID-19 pandemic appear to be particularly
vulnerable to forgone medical care," the study's co-authors wrote.











Christopher Cheney is the senior clinical care editor at HealthLeaders.








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