US Benchmark Data on Healthcare System Encounter-Related Time Toxicity: Top Conditions at the Population Level

OBJECTIVES: Disease treatment often requires a time investment for patients. An emerging patient-centric outcome is “time toxicity” or time spent encountering the healthcare system. This study seeks to identify which disease areas impose the greatest time constraints on US patients and potential areas where novel treatment approaches and healthcare innovation may give patients more healthy days at home.

METHODS: Using data from the Agency for Healthcare Research and Quality (AHRQ) and the National Center for Health Statistics (NCHS) (2019-2021), rates per 100,000 Americans were estimated for ambulatory care visits, ER visits and hospital days. The top conditions are reported based on ICD-10 codes or primary diagnosis groups.

RESULTS: Of the over 1 billion annual physician ambulatory care visits, the rate per 100,000 Americans was most prevalent for hypertension (16,853 visits), Type 2 diabetes mellitus (11,320 visits), and joint diseases (11,559 visits). Of the 140 million ER visits, most prevalent causes were for acute injury (7,017 visits), respiratory conditions (3,032 visits), and musculoskeletal conditions (2,806 visits). Finally, of the 33 million in-patient hospital discharges, the days per 100,000 were most prevalent for septicemia (6,034 days), COVID (3,689 days) and heart failure (1,865 days).

CONCLUSIONS: Time burden at the population level provides a key metric for healthcare system encounter-related toxicity. Time spent seeking healthcare matters to young and old alike and impacts patients in areas as diverse as workplace productivity, quality-of-life, caregiver burden, or end-of-life opportunity costs. More research is needed to understand how significant an impact today’s advanced solutions (e.g. tele-health, digital platforms, novel drug delivery methods) can lessen the patient time burden, benefit other healthcare system stakeholders (physician, payer) and drive areas for future innovation.