There's no question outpatient visits plummeted in the earliest days of the pandemic as providers scrambled to move care to virtual settings.
But as the year—and the roller coaster of COVID-19 cases nationwide it brought—went on, it turned out outpatient visits overall were down but still relatively stable, a Harvard University analysis published by The Commonwealth Fund found.
For the study, Harvard partnered with Phreesia, a healthcare technology company, to analyze data on changes in visit volume for a normal year compared to 2020 for the more than 50,000 providers that are Phreesia clients.
Office visits were down about 5% to 6% compared to previous winters when volumes typically rise, the analysis found.
"Over November and December, the nation witnessed an unprecedented rise in COVID-19 cases," researchers wrote in the report. "Coming on the heels of the holiday season, this COVID-19 surge affected nearly all states, exacerbating several challenges already facing care providers: treating patients exposed to the virus or infected by it; managing patients with non-COVID-19-related illnesses; keeping providers and staff healthy; and ensuring the financial viability of their practices."
Their work, they said, points "to the resiliency of outpatient practices in the face of these challenges, as the number of weekly outpatient visits overall remained stable."
Among the findings in the analysis:
- While in-person outpatient visits plummeted by nearly 60% in the earliest phase of the pandemic, they were only about 20% below baseline by about June 2020, the report showed. They'd nearly returned to baseline numbers by mid-September.
As in-person visits fell early on in the pandemic, telemedicine took off and jumped 12.5% above its baseline number of visits by early May. Telemedicine since dropped, falling steadily into October, they wrote. But then telemedicine use jumped in November and December again as the cases began to increase.
Visits to specialists in rheumatology and urology, as well as adult primary care, were up 8%, 6% and 5%, respectively, over their pre-pandemic volumes by December 2020, the report found. Pediatric volumes in December, however, were down 24% compared to their pre-pandemic volumes.
The researchers acknowledged the limitations to their work, such as the fact the sample of providers may not be representative of all organizations nationally or within a specific region. As well, they said, while same-day and walk-in visits are typically captured in the scheduling software, it is possible some unscheduled telephone encounters were not captured.
They also said workflow and documentation practices have likely shifted during the pandemic, which may have impacted the numbers.