How COVID-19 shaped the outpatient shift

Editor's Note

New research sheds light on the different ways that the COVID-19 pandemic influenced a significant shift in surgeries from inpatient to outpatient settings, with the most pronounced shift occurring for hip and knee replacements. The findings published December 6 in Sage Journals also showed greater declines in overall procedure volumes from patients in lower-income census tracts.

Data for the study came from medical claims data through Independence Blue Cross from 2018-2022 for 102 specific procedures to track surgery setting from before the pandemic and during the 2 years following the suspension of elective surgeries caused by the pandemic. As of 2022 data, inpatient volumes decreased and outpatient utilization correspondingly increased for 9 procedures, with orthopedic joint replacement procedures topping the list.

Another interesting trend from the study findings showed that patients from lower-income census tracts saw greater declines in overall procedure volumes compared to those from higher-income areas. Also, total allowed amounts decreased for procedures with outpatient migration, while out-of-pocket costs remained stable. The investigators suggested these data demonstrate potential implications for care access, care costs, and care equity.