Navigating the Currents of the Pandemic: A Comprehensive Analysis of Medicare Data Reflecting COVID-19's Impact on Cardiovascular Disease Healthcare Utilization

OBJECTIVES: The COVID-19 pandemic precipitated systemic disruptions in global healthcare, markedly impacting service provision. The ramifications for healthcare utilization among Medicare beneficiaries with cardiovascular disease (CVD)—a demographically significant and vulnerable population—warrant detailed exploration. This investigation seeks to elucidate variations in healthcare engagement for this cohort across multiple service domains during distinct phases of the pandemic.

METHODS: Leveraging the 100% Medicare fee-for-service research identifiable files (RIFs) from 2018 to 2023, this study quantified the mean healthcare service utilization per 1,000 CVD-afflicted patients. Analyzed services encompassed acute inpatient care, emergency room visits, hospital outpatient visits, and physician office consultations. Temporal divisions were established to contrast the pre-pandemic epoch (March 2018 to December 2019) with the pandemic (March 2020 to December 2021) and subsequent post-pandemic period (January 2022 to November 2023).

RESULTS: An aggregation of data from 22 million CVD patients under Medicare FFS was analyzed. Outpatient and physician office services showed a 4.5% decrease during the pandemic (95% CI= -6.7%, -2.1%) and a 9.3% decrease post-pandemic (95% CI= -11.4%, -6.8%). Inpatient service use saw a minor reduction post-pandemic by 0.7% (95% CI= -0.9%, -0.5%). Skilled nursing facility (SNF) services experienced a non-significant drop during the pandemic, yet post-pandemic figures showed a 1.8% decrease (95% CI= -2.1%, -1.5%).

CONCLUSIONS: Pandemic-induced shifts have resulted in a discernible contraction in healthcare utilization trajectories for CVD patients in the Medicare population, persisting into the post-pandemic landscape. The findings illuminate significant reshaping of healthcare utilization patterns, with telehealth solutions witnessing a surge, yet these results are insufficient to counterbalance the decline in traditional service use. These insights highlight the imperative for healthcare systems to adapt and prepare for enduring changes in patient engagement with services.