Abstract
Introduction: During March 2020, as the emergence of COVID-19 began to influence medical and social behaviors in the United States, oncology practices reported a disruption in normal referral and patient management patterns. Participants and staff of ASCO's PracticeNET learning network sought to explore and quantify the impact of this disruption through an analysis of patient activity at multiple hematology/oncology practices.
Methods: 20 practices submitted their billing data for analysis; practices were located in 14 states and ranged in size from 2 to 29 hematologists/oncologists. From this dataset we analyzed a total of 11,453 new patient and consult visits (Current Procedural Terminology codes 99201-99205, 99241-99245, 99251-99255, and 99341-99345) performed by hematologists/oncologists from February 9 to April 18, 2020. The number of visits performed from February 9 to March 14, 2020 was compared to visits performed from March 15 to April 18, 2020. A principal diagnosis was assigned to each visit following usual coding and billing practices.
Results: From February 9 to March 14, practices performed an average of 70.1 (median 55.5) new patient and consult visits per week. From March 15 to April 19, practices performed an average of 44.5 new patient and consult visits per week. The average decrease in visits among practices was 35% (95% confidence interval (CI): -42%, -29%). The decline in visits per practice ranged from -61% to -13%. New patient and consult visits for solid neoplasms decreased by an average of 22% (95% CI: -31%, -13%), visits for blood neoplasms decreased by an average of 36% (95% CI: -25%, -47%), and visits for benign hematology and circulatory disorders decreased by an average of 44% (95% CI: -53%, -34%).
Conclusions: Oncology practices experienced a decline in new patient and consult visits, first observed in the week of March 15. New patient and consult visits for blood neoplasms, benign hematology, and circulatory disorders experienced a greater decline than visits for solid neoplasms. The decrease in activity could be the result of prioritization of resources or changes in patient behavior in seeking care. Further study is necessary to quantify the impact of these findings on patient access and outcomes and to monitor recovery efforts.
Citation Format: Brian Bourbeau, Mou Guharoy, Elizabeth Garrett-Mayer, Stephen Grubbs, Paul Unger, Barbara McAneny, Richard L. Schilsky. Impact of COVID-19 pandemic on new patient and consult visits at 20 hematology/oncology practices in the ASCO PracticeNET learning network [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr PO-022.