Trends in Self-reported Forgone Medical Care Among Medicare Beneficiaries During the COVID-19 Pandemic

Evidence suggests that the COVID-19 pandemic has had a negative association with medical care access. As prior studies mainly focused on the initial stage of the COVID-19 pandemic, less is known about how trends in forgone medical care changed over time.

Park, et al. (2021) sought to examine trends in and reasons for forgone medical care among Medicare beneficiaries during the COVID-19 pandemic.

A total of 23,058 Medicare beneficiaries were included (13,005 women [56.4%]; 10,445 [45.3%] 75 years old and older). The survey response rates for each wave were 72.6%, 78.95, and 79.6%, respectively. The rates of reported forgone medical care because of COVID-19 decreased from the week of June 7, 2020, to the week of April 4 to 25, 2021, but the largest difference in the rates was found between June 7 and July 12, 2020 (22.4% to 15.9%). Physician-driven factors accounted for about 70% of the forgone medical care. The proportion of those who reported forgoing medical care because of physician-driven factors tended to decrease from 66.2% in the week of July 7, 2020, to 44.7% in the weeks of April 4 to 25, 2021. The likelihood of forgone medical care was 4 percentage points (95% CI, 0.03-0.05) higher among those who reported feeling more stressed or anxious than those who did not, 3 percentage points (95% CI, 0.01-0.04) higher among those who reported feeling more lonely or sad than those who did not, and 3 percentage points (95% CI, 0.01-0.04) higher among those who reported feeling less socially connected than those who did not.

The results of this cross-sectional survey study suggest that the COVID-19 pandemic may exacerbate existing barriers to care and lead Medicare beneficiaries to delay needed care. Policy makers must continue to identify effective means of meeting the forgone care backlog and maintaining continuity of care, especially for those with mental health problems.

Reference: Park S, et al. Trends in Self-reported Forgone Medical Care Among Medicare Beneficiaries During the COVID-19 Pandemic. JAMA Health Forum. 2021;2(12):e214299. doi:10.1001/jamahealthforum.2021.4299