COVID-19 Pandemic: Impacts on Primary Care Diane Rittenhouse, MD, - - PowerPoint PPT Presentation

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Dec 27, 2023 102 likes •182 views

COVID-19 Pandemic: Impacts on Primary Care Diane Rittenhouse, MD, MPH Senior Fellow, Mathematica Professor, University of California, San Francisco DRittenhouse@mathematica-mpr.com @dianerittenhous 1 Primary Care in Crisis

SLIDE 1

COVID-19 Pandemic: Impacts on Primary Care

⁄ Diane Rittenhouse, MD, MPH

⁄ Senior Fellow, Mathematica ⁄ Professor, University of California, San Francisco

⁄ DRittenhouse@mathematica-mpr.com ⁄ @dianerittenhous

SLIDE 2

Primary Care … in Crisis

⁄ Family Medicine, General Internal Medicine, and General Pediatrics ⁄ First contact care ⁄ Relationship-centered ⁄ Foundation of high-quality, low-cost, equitable health care system ⁄ Transformation for > 10 years ⁄ Chronically under-resourced

Financial investment
Fee-for-service payment
Human resources - workforce
Technical assistance

SLIDE 3

Data are presented as a percentage change in the number of visits of any type (in-person and telemedicine) in a given week from the baseline week (March 1–7). Source: Ateev Mehrotra et al., The Impact of the COVID-19 Pandemic on Outpatient Visits: Changing Patterns of Care in the Newest COVID-19 Hot Spots (Commonwealth Fund, Aug. 2020). https://doi.org/10.26099/yaqe-q550

Ambulatory care visits, by age

0% 10% 16-Feb 23-Feb 1-Mar 8-Mar 15-Mar 22-Mar 29-Mar 5-Apr 12-Apr 19-Apr 26-Apr 3-May 10-May 17-May 24-May 31-May 7-Jun 14-Jun 21-Jun 28-Jun 5-Jul 12-Jul 19-Jul 26-Jul Ages 0–2 Ages 3–5 Ages 6–17 Ages 18–64 Ages 65–74 Age 75+

SLIDE 4

Routine childhood immunizations

* VFC data represent the difference in cumulative doses of VFC-funded noninfluenza and measles-containing vaccines ordered by health care providers at weekly intervals between Jan 7–Apr 21, 2019, and Jan 6–Apr 19, 2020. US Department of Health and Human Services/Centers for Disease Control and Prevention MMWR / May 15, 2020 / Vol. 69 / No. 19

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0.00% 2.00% 4.00% 6.00% 8.00% 10.00% 12.00% 14.00%

Data are presented as a percentage, with the numerator being the number of telemedicine visits in a given week and the denominator being the number of visits in the baseline week (March 1–7). Telemedicine includes both telephone and video visits. Source: Ateev Mehrotra et al., The Impact of the COVID-19 Pandemic on Outpatient Visits: Changing Patterns of Care in the Newest COVID-19 Hot Spots (Commonwealth Fund, Aug. 2020). https://doi.org/10.26099/yaqe-q550

Telehealth visits

SLIDE 6

Primary Care Providers Speak:

⁄ The "I can do 4-6 weeks of this" transition to "this feels like a new/permanent normal" is crushing and demoralizing. Ways to build morale when everyone is at a computer workstation away from other staff (and patients) feels impossible. (Ohio) ⁄ I am seeing a counselor regularly, and clearly have compassion

fatigue. Pain from the daily treadmill, crying because of the broken

system locally and fractured national disaster, knowing how different it could be. (Virginia) ⁄ March-June the stress level was constant and severe. I had a physical and emotional meltdown in June and had to take a week off. Emotional exhaustion has also been affected by a physician colleague's suicide in May. (Oregon)

https://www.pcpcc.org/2020/07/14/primary-care-covid-19-week-16-survey

SLIDE 7

Primary Care - Moving Forward

⁄ Small independent primary care practice revenue needs to be stabilized ⁄ Primary Care investment needs to increase ⁄ Transition to population-based prospective payment (capitation) for primary care ⁄ Telehealth is here to stay – need to support with $ and TA ⁄ Primary care practices need both financial support and human support to continue to serve and continue to transform