Researchers Examine Foregone Medical Care Among Medicare Beneficiaries During Pandemic

Physician-driven factors such as closed physician offices have played a major role in foregone medical care for Medicare beneficiaries during the pandemic, study finds.

Forgone medical care for Medicare beneficiaries during the coronavirus pandemic has decreased over time and forgone medical care was more pronounced among Medicare beneficiaries who reported mental health problems, a recent study found.

Before the pandemic, delayed or forgone medical care was a known healthcare issue and previous research had linked it to poor health outcomes that inequitably impacted vulnerable patients. Other previous research has showed that about 40% of U.S. adults have reported forgone medical care during the pandemic, with fear of COVID-19 exposure cited among the reasons.

The recent study, which was published by JAMA Health Forum, includes data collected from more than 23,000 Medicare beneficiaries in three time periods: June 7 to July 12, 2020, Oct. 4 to Nov. 8, 2020, and Feb. 28 to April 25, 2021. The data was gathered from the Medicare Current Beneficiary Survey COVID-19 Supplement Public Use File.

The recent study features several key data points.

• 11.5% of Medicare beneficiaries reported forgone medical care because of COVID-19
   
• Dental care was the most common care that was delayed or forgone (4.3% of survey respondents), followed by prevention (4.0%) and checkups (3.9%)
   
• Rates of forgone medical care decreased in all three of the periods examined in the recent study, with the largest decrease found between June 7 and July 12, 2020 (22.4% to 15.9%)
   
• Most Medicare beneficiaries forwent medical care due to physician-driven factors, with the percentage of beneficiaries who forwent medical care because of physician-driven factors dropping from 66.2% in the week of July 7, 2020, to 44.7% in the weeks of April 4 to April 25, 2021
   
• From June 7 to July 12, 2020, the most common reported physician barrier was that the physician's office was closed
   
• From April 4 to April 25, 2021, the most common reported physician barrier was that the physician had reduced appointments
   
• The most common reported patient factor for foregoing care was that the patient felt risk of COVID-19 exposure and wanted to stay home
   
• Medicare beneficiaries who reported feeling more stressed or anxious than those who did not had a likelihood of foregoing medical care 4 percentage points higher
   
• Medicare beneficiaries who reported feeling more lonely or sad than those who did not had a likelihood of foregoing medical care 3 percentage points higher
   
• Medicare beneficiaries who reported feeling less socially connected than those who did not had a likelihood of foregoing medical care 3 percentage points higher

"The results of this cross-sectional survey study suggest that public health emergencies, such as pandemics, may exacerbate existing barriers to care and cause patients to delay needed care. Factors unique to the pandemic included closed physician’s offices, reduced appointment availability, and patient fear of contagion. Medicare beneficiaries who are experiencing heightened mental health problems associated with the COVID-19 pandemic appear to be particularly vulnerable to forgone medical care," the study's co-authors wrote.