Report: As ambulatory visits fell in California, kids saw steeper declines than adults

During the Covid-19 pandemic, ambulatory visit volumes fell by more than 50% across California, with one population seeing particularly sharp declines — children, according to a new report.

The report, released by Manifest MedEx, California’s largest nonprofit health information network, is based on an analysis of 4 million state residents who were continuously covered by the same insurer in 2020.

While outpatient visits dropped to a low of 50% below pre-pandemic levels at the end of March last year, visits eventually stabilized and then recovered to about 20% below their June 2019 level.

However, the ambulatory visit volume for adolescents and children decreased more than in adults. Visits for adolescents fell by 25% and for children over the age of 5, that figure fell by 36%.

The decrease could be explained by the fact that adolescents and children had fewer respiratory infections and that schools and sports required fewer doctor visits, but the decrease is worrying.

“It is concerning that children are having less contact with their pediatricians and teachers, both of whom play a key role in identifying medical, developmental and social problems, and it will be important for us to monitor children’s health use in the coming months. ,” said Claudia Williams, CEO of Manifest MedEx, in an email.

Another particularly worrying trend is the decline in the volume of preventive services, such as cancer screenings, which fell 20% to 40% during the California pandemic, Williams said. This includes declines in mammography screenings, which fell 20% below pre-pandemic levels; colonoscopy screenings, which decreased by 34%; and cervical cancer screenings, which fell by 41%.

“The lack of preventive care, such as cancer screening, can have a negative lasting effect, including diagnosis at later stages,” Williams said.

“It will be important to quickly catch up with these screening services and monitor whether cancer is diagnosed at later stages in the coming years,” she added.

In contrast, patient volumes for other services, such as hip arthroplasty and positron emission tomography scans, were only 3% and 2% lower than in 2019.

As 2020 progressed, visits recovered, although not to pre-pandemic levels. The number of outpatient visits fluctuated around 250,000 per month from October to December, while the number of Covid-19 cases rose from around 225,000 to 2 million. This shows that medical offices and Californians have become accustomed to living with the deadly disease and taking necessary precautions, the report states.

As visits continue to rise, health care providers need to catch up on missed care and identify and proactively reach out to patients most in need, such as those at high risk and those who have experienced gaps in care, Williams said.

Providers can do this by targeting campaigns to increase preventive cancer screening and ensure that every child and adolescent gets a wellness visit where referrals can be given for needed services, she said.

Photo: Geber86, Getty Images

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