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      Changes in home visit utilization during the COVID-19 pandemic: a multicenter cross-sectional web-based survey

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          Abstract

          Objective

          Home care is one of the essential community health care services; thus, identifying changes of home care utilization before and during the COVID-19 pandemic would be useful for researchers and policymaker to reconsider the home care system, the support needed for home care staff, and the collaborative system with hospitals in the COVID-19 era. We conducted a multicenter cross-sectional web-based anonymous survey of the directors of home visit facilities in Japan in August 2021.

          Results

          A total of 33 participants from 37 facilities responded to the survey. The number of patients dying at home and newly requested home visits increased during the COVID-19 pandemic (74.2%, 71.0%). One possible reason was the restricted visitation of inpatient facilities (93.5%). The underlying disease that the largest number of participants perceived as having increased compared with before the COVID-19 pandemic was cancer (51.6%). There were no significant differences in being in a rural area or the number of doctors in perceived changes in home visit utilization. Our study indicated that the director of home visit facilities thought the number of patients dying at home and newly requested home visits had increased compared with before the COVID-19 pandemic.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s13104-022-06128-7.

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          Most cited references20

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          Use and Content of Primary Care Office-Based vs Telemedicine Care Visits During the COVID-19 Pandemic in the US

          Key Points Question Is there a quantifiable association between the coronavirus disease 2019 (COVID-19) pandemic and the volume, type, and content of primary care encounters in the US? Findings In this cross-sectional analysis of the US National Disease and Therapeutic Index audit of more than 125.8 million primary care visits in the 10 calendar quarters between quarter 1 of 2018 and quarter 2 of 2020, primary care visits decreased by 21.4% during the second quarter of 2020 compared with the average quarterly visit volume of the second quarters of 2018 and 2019. Evaluations of blood pressure and cholesterol levels decreased owing to fewer total visits and less frequent assessment during telemedicine encounters. Meaning The COVID-19 pandemic was associated with changes in the structure of primary care delivery during the second quarter of 2020, with the content of telemedicine visits differing from that of office-based encounters.
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            Changes in Health Services Use Among Commercially Insured US Populations During the COVID-19 Pandemic

            Key Points Question How did health services use among commercially insured populations change during the initial phase of the coronavirus disease 2019 (COVID-19) pandemic in the United States? Findings This cross-sectional study with a claims-based analysis of 6.8 million commercially insured individuals found that during the initial phase of the COVID-19 epidemic in March and April of 2020, patients significantly reduced use of preventive and elective care and increased use of telemedicine but not enough to offset reductions in in-person care. Racial/ethnic and income disparities were seen in changes in use of in-person care and telemedicine. Meaning In this study, the initial 2 months of the COVID-19 pandemic were associated with large reductions in use of health services; future policy initiatives should ensure that these reductions do not adversely affect patient health.
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              Impact of the COVID-19 Pandemic on Health Care Utilization in a Large Integrated Health Care System: Retrospective Cohort Study

              Background The COVID-19 pandemic has caused an abrupt reduction in the use of in-person health care, accompanied by a corresponding surge in the use of telehealth services. However, the extent and nature of changes in health care utilization during the pandemic may differ by care setting. Knowledge of the impact of the pandemic on health care utilization is important to health care organizations and policy makers. Objective The aims of this study are (1) to evaluate changes in in-person health care utilization and telehealth visits during the COVID-19 pandemic and (2) to assess the difference in changes in health care utilization between the pandemic year 2020 and the prepandemic year 2019. Methods We retrospectively assembled a cohort consisting of members of a large integrated health care organization, who were enrolled between January 6 and November 2, 2019 (prepandemic year), and between January 5 and October 31, 2020 (pandemic year). The rates of visits were calculated weekly for four settings: inpatient, emergency department (ED), outpatient, and telehealth. Using Poisson models, we assessed the impact of the pandemic on health care utilization during the early days of the pandemic and conducted difference-in-deference (DID) analyses to measure the changes in health care utilization, adjusting for the trend of health care utilization in the prepandemic year. Results In the early days of the pandemic, we observed significant reductions in inpatient, ED, and outpatient utilization (by 30.2%, 37.0%, and 80.9%, respectively). By contrast, there was a 4-fold increase in telehealth visits between weeks 8 (February 23) and 12 (March 22) in 2020. DID analyses revealed that after adjusting for prepandemic secular trends, the reductions in inpatient, ED, and outpatient visit rates in the early days of the pandemic were 1.6, 8.9, and 367.2 visits per 100 person-years ( P <.001), respectively, while the increase in telehealth visits was 272.9 visits per 100 person-years ( P <.001). Further analyses suggested that the increase in telehealth visits offset the reduction in outpatient visits by week 26 (June 28, 2020). Conclusions In-person health care utilization decreased drastically during the early period of the pandemic, but there was a corresponding increase in telehealth visits during the same period. By end-June 2020, the combined outpatient and telehealth visits had recovered to prepandemic levels.
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                Author and article information

                Contributors
                junhamano@md.tsukuba.ac.jp
                tachikawa@md.tsukuba.ac.jp
                shotaka72@gmail.com
                ekoyama.saori.gn@un.tsukuba.ac.jp
                nagaoka3taro@gmail.com
                sachiko-ozone@md.tsukuba.ac.jp
                smash422@md.tsukuba.ac.jp
                kuropoko713@yahoo.co.jp
                4632tetsu@md.tsukuba.ac.jp
                Journal
                BMC Res Notes
                BMC Res Notes
                BMC Research Notes
                BioMed Central (London )
                1756-0500
                7 July 2022
                7 July 2022
                2022
                : 15
                : 238
                Affiliations
                [1 ]GRID grid.20515.33, ISNI 0000 0001 2369 4728, Division of Clinical Medicine, Faculty of Medicine, , University of Tsukuba, ; 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8575 Japan
                [2 ]GRID grid.20515.33, ISNI 0000 0001 2369 4728, Department of Disaster and Community Psychiatry, Faculty of Medicine, , University of Tsukuba, ; Tsukuba, Japan
                [3 ]GRID grid.412814.a, ISNI 0000 0004 0619 0044, University of Tsukuba Hospital, ; Tsukuba, Japan
                [4 ]GRID grid.20515.33, ISNI 0000 0001 2369 4728, Department of Family Medicine, General Practice and Community Health, Faculty of Medicine, , University of Tsukuba, ; Tsukuba, Japan
                [5 ]Department of General Medicine, Tsukuba Central Hospital, Kamikashiwada 4-58-1, Ushiku, Ibaraki 300-1232 Japan
                [6 ]GRID grid.20515.33, ISNI 0000 0001 2369 4728, Division of Clinical Medicine, Department of Psychiatry, Faculty of Medicine, , University of Tsukuba, ; 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8575 Japan
                Author information
                http://orcid.org/0000-0003-0304-9881
                Article
                6128
                10.1186/s13104-022-06128-7
                9261221
                35799212
                db36b540-e4a6-48ab-8dd4-fd6c061df0af
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 31 March 2022
                : 21 June 2022
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001691, Japan Society for the Promotion of Science;
                Award ID: 19K10551
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100004398, Mitsubishi Foundation;
                Award ID: 201930027
                Award Recipient :
                Categories
                Research Note
                Custom metadata
                © The Author(s) 2022

                Medicine
                home visits,covid-19 pandemic,multicenter study,cross-sectional study
                Medicine
                home visits, covid-19 pandemic, multicenter study, cross-sectional study

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