COVID-19’s Impact on Your Medical Care

Posted on September 27, 2022

The pandemic has decreased the effectiveness of performance of the US health system in the areas of costs, quality, access and health outcomes. Burnout among physicians and front-line nurses, respiratory therapists and others has taken its toll. Findings from the Peterson-KFF Health System Tracker reveal the pandemic resulted in significant disruptions to long-standing trends: 1. The tragic number of deaths during the pandemic has driven US life expectancy down by 1.8 years compared to

The pandemic has decreased the effectiveness of performance of the US health system in the areas of costs, quality, access and health outcomes. Burnout among physicians and front-line nurses, respiratory therapists and others has taken its toll.

Findings from the Peterson-KFF Health System Tracker reveal the pandemic resulted in significant disruptions to long-standing trends:

1. The tragic number of deaths during the pandemic has driven US life expectancy down by 1.8 years compared to before the pandemic. This is three times the drop seen in peer nations.
2. Health services utilization dropped in 2020 due to delayed and forgone care and has yet to fully rebound.
3. In 2020, out-of-pocket and private insurance spending declined for the first time in recorded history, while overall health spending in the US grew, driven up by federal relief.
4. The rapid rise in telemedicine use helped access to care during the pandemic, however one in four adults reported delaying or forgoing care due to the pandemic.[i]

Americans are also reporting higher rates of anxiety (work and burnout) and depression. The World Health Organization (WHO) notes a 35% increase in the prevalence of anxiety and depression worldwide.[ii] Stress from social isolation financial concerns, loneliness, ongoing fear of infection, pressures from caring for a loved one suffering and grief from a COVID death, suicide, or overdose, increased substance use and suicidal ideation.

There’s been a huge uptick in mental health conditions. Nearly one billion people worldwide suffer from a mental health disorder. In the U.S. alone, 1 in 5 adults (about 52.9 million people) experience a mental illness. Yet just 46.2 percent of U.S. adults with mental illness receive treatment.

The costs of poor mental health and its related consequences are projected to reach $6 trillion globally by 2030, up from $2.5 trillion in 2010. That’s more than the costs associated with cancer, diabetes, and respiratory ailments combined.

Covid-19 has also served to reveal gaps in care. Supply and drug shortages have and to some degree continue to disrupt care. The decline in health screening, hospitalizations and emergency department visits continue due to fear of infection. This is leading to an increase in diseases not yet diagnosed, resulting in delays in treatment.

Impact on Patient Care Post Pandemic

It comes as no surprise that the COVID-19 pandemic has put extreme stress on the health care workforce in this country. Workforce shortages as well as increased health care worker burnout, exhaustion, and trauma have exacerbated pre-existing workforce shortages and maldistribution, as well as in a workforce where burnout, stress, and mental health problems were already significant problems.[iii]

Pre covid-19, health care was a kind of like a “one-way street.” Doctors prescribed care and “good” patients followed directions. When you needed to be admitted to the hospital, you continued to follow directions, trusting that the nurse was giving you the best care, correctly administering prescribed medications and treatments, technicians, dietiaians and others were following orders, etc.

Post covid-19, while listening to care partner hospitalization experiences of their loved ones and client outcomes, I have come to appreciate how the pandemic has brought to the fore front of the need for two-sided communication, advocacy and medical care navigation for ourselves and those we care about.

No arguing nurses are overwhelmed. They are expected to now handle more patients than they should. The nurse-to-patient ratio (the number of patients a nurse provides care to during each shift) now normally exceeds more patients than they should—even though studies show a nurse who is responsible for fewer patients, yields better outcomes.

Here’s what you can do to provide the best possible outcome for yourself or a loved one.

Self-Advocacy or Care Partner Tips:

Office Visits

· Prep for the visit by reviewing your medical records. Think about what you want to accomplish. If more than one, list them in order of priority. Take notes.

· Wrap up with a discussion for next steps: what does s/he recommend, what more do you need to learn? Is a second opinion needed?

· Bring a family member or friend with you to: take notes for you – to review later, help remind you of the questions you want to ask. Help you moderate the conversation, if needed.

Hospital Care

· Always ask whether you’re admitted . When in the ER, should the ER physician make a comment about observing the patient (yourself or a loved one), for a while (overnight or even days), ask if you (he or she) are/is going to be admitted. You can actually stay in the ER at the hospital in observation status, but never officially be 'admitted.'

It’s important to know epically for Medicare patents. If after a day or two they are sent to a nursing home for rehab, Medicare won’t pay for it unless they were actually admitted.

· Any patient who is admitted to the hospital and is: elderly or frail, physically or mentally unstable, unable to walk, speak, find or use the nurse call button or dependent on oxygen or with an IV line, is in need of a care partner or an advocate (friend or professional).

· Admitted? Log everything. Keep a notebook. Write down your questions, log who’s coming into your room, and track conversations with each physician, case manager and other.

With so many “hospital” people coming to see you, it’s easy to forget who you spoke with, when and for what reason. It will also be helpful once you receive the bill to be able to verify make sure there are no errors (it happens more often than you think).

· Sanitize everything. "Superbugs live everywhere, and they can travel. Even if your doctor washed his hands, that sparkling white coat brushing against your bed can easily transfer a dangerous germ from someone else’s room. Ask for bleach and alcohol wipes to clean bed rails, remotes, doorknobs, phones, call buttons, and toilet flush levers. Wash your hands before you eat."[iv]

· If you are on the phone with a family member and a doctor comes into your room, do not discontinue the call. Instead have a 3-way conversation to and take notes.

Always remember your goal is to get the best medical care. Now more than ever before effective communication is essential.

While nurses and care providers have agendas for multiple patients, a professional patient advocate has 1 agenda – the well-being of the patient. We serve in an information and facilitation role empowering clients by providing background knowledge of the healthcare system - providing an awareness of options, then empowering with confidence in voicing their care goals and choices.

Questions, additional information or comments, visit: https://patientadvocatesofswfl.com or email: [email protected].

[i] Tracking the Pandemic’s Effects On Health Outcomes, Costs And Access To Care. Lane, Kenneth, Cox, Cyntuhia, Amin, Krutika, Tettamanti, Nicky, Jurani, Nisahs, Wager, Emma, & Ortaliza, Jared. Health Affairs Forefront. 02/03/22. Tracking The Pandemic's Effects On Health Outcomes, Costs, And Access To Care | Health Affairs.
[ii] World Health Organization (WHOP COVID-19 pandemic triggers 25% increase in prevalence of anxiety and depression worldwide (who.int) March 2, 2022.
[iii] Impact of the COVID-19 Pandemic on the Hospital and Outpatient Clinician Workforce: Challenges and Policy Responses | ASPE (hhs.gov). March 3, 2022.
[iv] Karen Curtiss, The Care Partner Project and author of Safe & Sound in the Hospital: Must-Have Checklists and Tools for Your Loved One’s Care.