Cigna: Patients deferring care for acute needs like appendicitis, heart conditions

While hospitals have put elective procedures on pause during the pandemic, patients seeking care for serious health needs have also decreased significantly, new data from Cigna show. 

Researchers at the insurer studied care utilization among their commercial group and individual plan members between January and March across seven conditions and found decreases in hospitalizations across the board. 

For example, the hospitalization rate related to atrial fibrillation decreased by 35% between February and March.  

Large numbers of patients pushing off care for acute needs could have major repercussions as the industry emerges from the pandemic, said Saif Rathore, M.D., head of data and analytic innovation at Cigna and one of the report’s authors.

“This is part of us trying to sound the alarm,” he told FierceHealthcare. “There will be consequences for this kind of care deferral.” 

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Other conditions included in the study are transient ischemic attacks, or “mini-strokes,” which saw hospitalization rates decrease by 31% in that same window. Rates associated with epilepsy and seizures decreased by 28%, and hospitalization rates for gastrointestinal bleeding were down by 24%. 

Between February and March, hospitalization rates for aortic aneurysm and dissection decreased by 22%, for acute appendicitis by 13% and for acute coronary syndromes by 11%. 

Glen Stettin, M.D., senior vice president and chief innovation officer at Express Scripts and another of the report’s authors, told FierceHealthcare that the team decided to examine these rates after hearing anecdotally from hospitals and other industry colleagues that they were seeing such declines. 

Stettin said these are all conditions that are high risk and have potentially lifesaving treatments, so, if patients are experiencing such symptoms, they should call their doctor or emergency medical services. 

“The danger of having a heart attack is much greater than the hypothetical issue of, ‘you might catch COVID-19,’ because you probably won’t,” Stettin said. 

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Rathore said the team was surprised by the size of these decreases and that they were found across all seven conditions, because going without treatment for these conditions can have serious consequences. 

Stettin added that providers can help encourage patients to seek care in these situations by developing a care plan with those at high risk for certain conditions and having open conversations that affirm they should seek care in an emergency situation even if they should stay home otherwise. 

“We need to be able to walk and chew gum,” Rathore said. “Yes, focus on COVID and make sure they’re handling COVID, but not at the cost of letting patients leave other things on the table.”