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Changes in Primary Care Visits in the 24 Weeks After COVID-19 Stay-at-Home Orders Relative to the Comparable Time Period in 2019 in Metropolitan Chicago and Northern Illinois.
J Prim Care Community Health. 2020 Jan-Dec; 11:2150132720969557.JP

Abstract

OBJECTIVE

In this brief report, we characterize pediatric primary care service utilization in metropolitan Chicago over the first 24 weeks of the COVID-19 pandemic response in relation to the comparable time period in 2019.

METHODS

We examined retrospective visit and billing data, regardless of payer, from 16 independent pediatric practices that utilize a common electronic medical record platform within an Accountable Care Organization of 252 pediatricians in 71 offices throughout metropolitan Chicago. We categorized visits as Well-Child and Immunization-Only (WC-IO) or Other types and identified visits with a telemedicine billing modifier. Diagnoses for Other visits were tallied and categorized using the Agency for Healthcare Research and Quality Clinical Classification System. We summarized counts of visits and the proportion of visits with a telemedicine billing modifier in one-week epochs for 2020 compared with 2019.

RESULTS

There were 102 942 total visits (72 030 WC-IO; 30 912 Other) in 2020 and 144 672 visits (80 578 WC-IO; 64 094 Other) in 2019. WC-IO visits in 2020 were half of 2019 visits at the start of the Illinois Stay-at-Home Order and returned greater than 90% of 2019 visits in 8 weeks. Other visit types have remained below 70% of 2019 visits. A telemedicine billing modifier peaked in mid-April (21% of all visits) and declined to <10% of all visits in June (Phase 2 reopening). The top 10 most common diagnoses differed between years.

CONCLUSIONS

Recovery of well child and immunization visits suggests that practice-level efforts and policy change can ensure children receive recommended care as the pandemic evolves.

Authors+Show Affiliations

Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA. Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA. Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

33174495

Citation

Macy, Michelle L., et al. "Changes in Primary Care Visits in the 24 Weeks After COVID-19 Stay-at-Home Orders Relative to the Comparable Time Period in 2019 in Metropolitan Chicago and Northern Illinois." Journal of Primary Care & Community Health, vol. 11, 2020, p. 2150132720969557.
Macy ML, Huetteman P, Kan K. Changes in Primary Care Visits in the 24 Weeks After COVID-19 Stay-at-Home Orders Relative to the Comparable Time Period in 2019 in Metropolitan Chicago and Northern Illinois. J Prim Care Community Health. 2020;11:2150132720969557.
Macy, M. L., Huetteman, P., & Kan, K. (2020). Changes in Primary Care Visits in the 24 Weeks After COVID-19 Stay-at-Home Orders Relative to the Comparable Time Period in 2019 in Metropolitan Chicago and Northern Illinois. Journal of Primary Care & Community Health, 11, 2150132720969557. https://doi.org/10.1177/2150132720969557
Macy ML, Huetteman P, Kan K. Changes in Primary Care Visits in the 24 Weeks After COVID-19 Stay-at-Home Orders Relative to the Comparable Time Period in 2019 in Metropolitan Chicago and Northern Illinois. J Prim Care Community Health. 2020 Jan-Dec;11:2150132720969557. PubMed PMID: 33174495.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Changes in Primary Care Visits in the 24 Weeks After COVID-19 Stay-at-Home Orders Relative to the Comparable Time Period in 2019 in Metropolitan Chicago and Northern Illinois. AU - Macy,Michelle L, AU - Huetteman,Patricia, AU - Kan,Kristin, PY - 2020/11/11/entrez PY - 2020/11/12/pubmed PY - 2020/11/24/medline KW - COVID-19 KW - pediatric KW - primary care KW - utilization SP - 2150132720969557 EP - 2150132720969557 JF - Journal of primary care & community health JO - J Prim Care Community Health VL - 11 N2 - OBJECTIVE: In this brief report, we characterize pediatric primary care service utilization in metropolitan Chicago over the first 24 weeks of the COVID-19 pandemic response in relation to the comparable time period in 2019. METHODS: We examined retrospective visit and billing data, regardless of payer, from 16 independent pediatric practices that utilize a common electronic medical record platform within an Accountable Care Organization of 252 pediatricians in 71 offices throughout metropolitan Chicago. We categorized visits as Well-Child and Immunization-Only (WC-IO) or Other types and identified visits with a telemedicine billing modifier. Diagnoses for Other visits were tallied and categorized using the Agency for Healthcare Research and Quality Clinical Classification System. We summarized counts of visits and the proportion of visits with a telemedicine billing modifier in one-week epochs for 2020 compared with 2019. RESULTS: There were 102 942 total visits (72 030 WC-IO; 30 912 Other) in 2020 and 144 672 visits (80 578 WC-IO; 64 094 Other) in 2019. WC-IO visits in 2020 were half of 2019 visits at the start of the Illinois Stay-at-Home Order and returned greater than 90% of 2019 visits in 8 weeks. Other visit types have remained below 70% of 2019 visits. A telemedicine billing modifier peaked in mid-April (21% of all visits) and declined to <10% of all visits in June (Phase 2 reopening). The top 10 most common diagnoses differed between years. CONCLUSIONS: Recovery of well child and immunization visits suggests that practice-level efforts and policy change can ensure children receive recommended care as the pandemic evolves. SN - 2150-1327 UR - https://www.unboundmedicine.com/medline/citation/33174495/Changes_in_Primary_Care_Visits_in_the_24_Weeks_After_COVID_19_Stay_at_Home_Orders_Relative_to_the_Comparable_Time_Period_in_2019_in_Metropolitan_Chicago_and_Northern_Illinois_ L2 - https://journals.sagepub.com/doi/10.1177/2150132720969557?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -