While many headlines focus on the direct impact of the COVID-19 pandemic on healthcare providers, the past 18 months have also changed the types of care people were willing to seek out, as well as when and how they engaged healthcare providers. As we move into the fall and winter of 2021, here are six key ways the pandemic continues to impact patient care.
Large employers prepare for increased 2022 spending
According to a new survey by Business Group on Health, 94% of employers anticipate an increase in 2022 medical spending related to delayed care. While some employees put off routine medical screenings due to concerns about potential COVID-19 exposure in doctors’ offices and clinics, others were forced to delay diagnostics and elective surgeries due to PPE shortages and overwhelmed hospital systems. The same survey found that 91% of employers were also concerned about long-term mental health impacts of the pandemic, both in terms of new diagnoses and existing patients who were unable to maintain their pre-pandemic therapies and treatments.
New cancer diagnoses continue to decline
A research letter in the JAMA Network Open looked at the rate of new cancer diagnoses from March 2020 through March 2021. Early in the pandemic, healthcare professionals were concerned that patients were avoiding or delaying routine cancer screenings and were more hesitant to schedule in-person doctor visits due to concerns about COVID-19 exposure. Researchers looked at early pandemic trends in newly-identified cases of eight common cancers (prostate, breast, colorectal, lung, pancreatic, cervical, gastric, and esophageal) and found a 46.4% drop in expected diagnoses in March and April 2020. While diagnosis rates improved over the summer of 2020, the winter period of November 2020 to March 2021 saw a smaller, but still statistically significant drop, with new cancer diagnoses 19.1% lower than in pre-pandemic times.
Delayed cancer screenings lead to increased late-stage diagnoses
When the American Society for Radiation Oncology (ASTRO) surveyed members early in 2021 about trends related to the COVID-19 pandemic, two-thirds of doctors reported an increase in patients with advanced disease, compared to before the pandemic. Nearly 75% also reported that patients had missed routine cancer screenings, delaying their diagnoses and treatment. Additionally, the majority of clinics reported a decline in overall patient volume in 2020, with 81% seeing fewer patients referred for radiation therapy and 75% seeing delays in patients initiating treatment.
Among existing patients, 66% experienced disruptions to their treatment plans, often the result of the patient or caregiver quarantining after exposure or contracting COVID-19.
Independent medical practices are rebounding
2020 was a difficult year for independent medical practices, forcing them to react quickly to changing guidance and patient needs, while balancing staff safety, unplanned expenditures, and decreased income. But the 2021 State of the Independent Practice survey found that “independent practices feel stronger, resilient, and positive about the future of their practice and the industry.” While 11% of clinics closed completely at some point during the pandemic, they remain committed to their independence–86% of respondents do not plan to merge with hospitals or change their partnerships. By accelerating their adoption of new technologies, practices were able to simplify their back office needs, while improving overall patient experience.
More providers embrace telemedicine and telehealth
One bright spot for medical practices was the enhanced use of telemedicine during the pandemic. In the 2021 State of the Independent Practice study, nearly 80% of medical providers report they now offer telehealth services. In fact, more than a quarter of clinics reported that telehealth made up more than 75% of their current patient visits. The ability to build trusted patient-provider relationships is a key factor mentioned by independent practices when talking about why they choose to remain independent. Telehealth services allow independent practitioners to continue patient visits and conduct follow-ups in a safe, personalized way.
Nursing shortages could get worse
One ongoing challenge of the pandemic is the increased workload and emotional stress being felt by nurses who provide direct patient care. A recent survey by McKinsey found that nearly a quarter of nurses in direct patient care were considering leaving their positions in the next year. Of those who are considering leaving, 60% said they were more likely to leave now than they were in early 2020 and half were considering leaving the nursing profession entirely.
A similar study conducted in February 2021 by the American Nurses Association found nearly 20% of nurses intended to leave their current positions within the six months, with most citing “work is negatively affecting my health/well-being” (47%) and insufficient staffing (45%) as their top reasons for leaving.
All of these trends have implications for patient care in the months and years to come. While it’s natural to focus on the direct, immediate impacts of COVID-19 on the healthcare system, it’s critical for healthcare practitioners to be mindful of the ways the pandemic is influencing patient decisions and experience across the healthcare industry.