Patients previously considered low-risk became sicker and health disparities likely widened because of clinical staff shortages and volume surges during the COVID-19 pandemic. As a result, care delivery models need to evolve to make up the backlog and meet the ongoing needs of those whose ailments manifested or became more severe because they couldn’t receive treatment.
The pandemic, along with the healthcare system’s response, have had a disproportionate effect on older and sicker patients as well as people from underserved communities that’s going to linger. The public health emergency also highlighted and exacerbated staffing shortages, leaving a smaller, exhausted workforce to deal with the clinical consequences of deferred care. The pandemic eventually will go away, but the patients who didn’t get the treatment they needed will not.
The impact of delayed care on patients is still being empirically explored, but a general consensus has emerged: Many became sicker and diseases progressed undetected as preventive care and screening went by the wayside. Wellness visits declined 69%, breast cancer screenings dropped 88% and childhood vaccinations for measles, mumps and rubella fell 60% as people stayed clear of the healthcare system in 2020, according to data from UnitedHealthcare.
Hospitals are grappling right now with how to optimize their workforces to face these challenges by reconsidering how care is delivered. Telehealth and value-based care will play critical roles.
Crisis standards of care
The number of hospitals that entered crisis standards of care during the pandemic hasn’t been counted, and the ways they deployed—or didn’t deploy—resources changed over time. By last year, hospitals had expanded surge capacity and supplies of ventilators and personal protective equipment but became increasingly short-staffed. As of last month, 27% reported critical shortages to the Health and Human Services Department.
During crisis levels in the early phases of the pandemic, mortality rates spiked as hospitals rationed care. One-quarter of COVID-19 deaths between March and August 2020 were attributable to overstretched hospitals, according to the National Institutes of Health. Patients with the most serious non-coronavirus illnesses suffered under the same conditions.