The COVID-19 pandemic disrupted the practice of medicine nationwide, especially in those early months when much of the country was on lockdown.
To learn more about how COVID-19 impacted patient care, a team of researchers examined trends in practice interruptions, sharing their findings in JAMA.
The group analyzed data from 547,849 Medicare physician claims for 100% of fee-for-service beneficiaries from Jan. 1, 2019, to Dec. 30, 2020. They also counted the number of claims billed every month by each physician.
In the analysis, practice interruption was defined as a month in which a physician who had previously billed Medicare billed zero Medicare claims.
Moreover, interruptions with return were defined as the ones for which the physician resumed billing Medicare within six months of the last billing month and interruptions without return as those for which the physician did not resume billing Medicare within six months.
Physicians in training, pediatricians, and physicians who billed fewer than 50 Medicare claims during 2018 were excluded from the analysis.
According to the authors, practice interruption rates were comparable before and during the COVID-19 pandemic apart from an increase in April 2020, when 6.93% of physicians billing Medicare had a practice interruption. In April 2019, that number was just 1.43%.
“Most practice interruptions were temporary, though not all," wrote authors Hannah T. Neprash, PhD, of the University of Minnesota School of Public Health and Michael E. Chernew, PhD, of Harvard Medical School. "The pandemic appears to have impeded return to practice more for older physicians than for younger physicians, consistent with anecdotal reports and survey findings regarding intent to close practices, retire, or otherwise transition away from clinical medicine."
Also, 1.14% of physicians discontinued practice in April 2020 and did not return, compared with 0.33% in April 2019.
The rise between April 2019 and April 2020 in interruption rates and interruption-without-return rates was greater for physicians 55 years old and older than younger physicians.
The groups that experienced greater increases in practice interruption rates in April 2020 vs April 2019 included female physicians, specialists, physicians in smaller practices, those not in a health professional shortage area and those practicing in a metropolitan area.
What is the long-term impact of this spike in interruptions? The authors concluded that more research is needed to find out.
Read the full research letter here.