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The fact that there was an obvious decline in hospital inpatient admissions in the recent past and that America had fewer physician visits than most of its peer industrial countries is no longer a secret (Tikkanen, 2017). For instance, between 2005 and 2014 the rate of inpatient stays per 100,000 population significantly decreased across all age groups across America (McDermott et al., 2017). Another study reported that rural hospitals experienced an average change in inpatient average daily census of -13% between 2011 and 2017(Malone et al., 2021). According to more recent Epic Health Research Network’s data, hospital admissions remained below expected levels in 2021(Gallagher et al., 2021). Gallagher et al. (2021) further mention that, over the first quarter of 2021, hospital admission rates were 89.4% of what would have been expected in the absence of the pandemic. The authors clearly mention that even if patients with a COVID-19 diagnosis are removed, all other admissions are 80.7% of expected levels based. After analyzing Epic Health Research Network’s admissions data by age, Heist et al. (2021) reported that non-COVID-19 admissions for patients aged 65 and older were just in the range of 53.4-63.0% of predicted levels in April 2020, compared to 68.6-75.1% of predicted levels for younger patients. Their broader study involving data from 47 states showed that hospitals in the Northeast had experienced the steepest decline in non-COVID-19 admissions early in the pandemic, although non-COVID-19 admissions remained at a higher level than other regions in the fall of 2020. The trend is likely to continue, according to an article on a Moody’s investors service data analysis (Kelly, 2022). The author states that Tenet, which has been building its outpatient business through its United Surgical Partners unit, reported a 9% rise in outpatient visits during the fourth quarter 2021, even if total admissions declined 4% from the year before. HCA Healthcare saw patient volumes increase in most categories during the period, except for inpatient services (Kelly, 2022).
According to Heist et al. (2021), decline in inpatient admissions could create serious negative consequences on patients’ health, as well as on hospitals’ financial stability. As per Tikkanen (2017), even though Americans use some expensive technologies such as Magnetic resonance imaging outperforms its peers in terms of preventive measures, the U.S. still have the lowest life expectancy, highest suicide rate, highest chronic disease burden, and highest obesity rate among industrialized countries. Tikkanen (2017) specifically mentioned that this can be because Americans have had fewer physician visits than their peers in most industrialized countries. The resulting falling levels of non-COVID-19 admissions suggest that people may be delaying care in ways that could be harmful to their long-term health, and the impact of that forgone care should be an important subject of future analysis (Heist et al., 2021). Besides, older patients who were at a higher risk of serious illness or death due to COVID-19 were more reluctant than younger patients to enter a hospital, if not necessary (Heist et al., 2021). A recent study presents similar findings speculates that the declines in medical admissions may have been due in part to a fear of contracting COVID-19 by both physicians and patients, greater use of telemedicine, and possibly lower transmission rates of non-COVID-19 diseases following stay-at-home orders (Dartmouth Giesel School of Medicine, 2020).