Shifts in ophthalmic care utilization during the COVID-19 pandemic in the US

Li, C; Lum, F; Chen, EM; Collender, PA; Head, JR; Khurana, RN; Cunningham, ET; Moorthy, RS; Parke, DW; McLeod, SD

COVID-19 Collection

Journal article

Shifts in ophthalmic care utilization during the COVID-19 pandemic in the US

Abstract:: BACKGROUND: Healthcare restrictions during the COVID-19 pandemic, particularly in ophthalmology, led to a differential underutilization of care. An analytic approach is needed to characterize pandemic health services usage across many conditions. METHODS: A common analytical framework identified pandemic care utilization patterns across 261 ophthalmic diagnoses. Using a United States eye care registry, predictions of utilization expected without the pandemic were established for each diagnosis via models trained on pre-pandemic data. Pandemic effects on utilization were estimated by calculating deviations between observed and expected patient volumes from January 2020 to December 2021, with two sub-periods of focus: the hiatus (March-May 2020) and post-hiatus (June 2020-December 2021). Deviation patterns were analyzed using cluster analyses, data visualizations, and hypothesis testing. RESULTS: Records from 44.62 million patients and 2455 practices show lasting reductions in ophthalmic care utilization, including visits for leading causes of visual impairment (age-related macular degeneration, diabetic retinopathy, cataract, glaucoma). Mean deviations among all diagnoses are 67% below expectation during the hiatus peak, and 13% post-hiatus. Less severe conditions experience greater utilization reductions, with heterogeneities across diagnosis categories and pandemic phases. Intense post-hiatus reductions occur among non-vision-threatening conditions or asymptomatic precursors of vision-threatening diseases. Many conditions with above-average post-hiatus utilization pose a risk for irreversible morbidity, such as emergent pediatric, retinal, or uveitic diseases. CONCLUSIONS: We derive high-resolution insights on pandemic care utilization in the US from high-dimensional data using an analytical framework that can be applied to study healthcare disruptions in other settings and inform efforts to pinpoint unmet clinical needs.

Publication status:: Published

Peer review status:: Peer reviewed

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APA Style

Li, C., Lum, F., Chen, E. M., Collender, P. A., Head, J. R., Khurana, R. N., Cunningham, E. T., Moorthy, R. S., Parke, D. W., & McLeod, S. D. (2023). Shifts in ophthalmic care utilization during the COVID-19 pandemic in the US. Communications Medicine, 3(1), 181–181.

MLA Style

Li, C, et al. “Shifts in Ophthalmic Care Utilization during the COVID-19 Pandemic in the US.” Communications Medicine, vol. 3, no. 1, 2023, pp. 181–81.

Chicago Style

Li, C, F Lum, EM Chen, et al. 2023. “Shifts in Ophthalmic Care Utilization during the COVID-19 Pandemic in the US.” Communications Medicine 3 (1): 181–81.
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