Effects of State Covid-19 Closure Policy on Non-Covid-19 Health Care Utilization

70 Pages Posted: 4 Aug 2020 Last revised: 27 Jun 2021

See all articles by Engy Ziedan

Engy Ziedan

Tulane University

Kosali Ilayperuma Simon

Indiana University Bloomington - School of Public & Environmental Affairs (SPEA); National Bureau of Economic Research (NBER)

Coady Wing

Indiana University

Date Written: July 2020

Abstract

The U.S. health care system has experienced great pressure since early March 2020 as it pivoted to providing necessary care for COVID-19 patients. But there are signs that non-COVID-19 care use declined during this time period. We examine near real time data from a nationwide electronic healthcare records system that covers over 35 million patients to provide new evidence of how non-COVID-19 acute care and preventive/primary care have been affected during the epidemic. Using event study and difference-in-difference models we find that state closure policies (stay-at-home or non-essential business closures) are associated with large declines in ambulatory visits, with effects differing by type of care. State closure policies reduced overall outpatient visits by about 15-16 percent within two weeks. Outpatient visits for health check-ups and well care experience very large declines during the epidemic, with substantial effects from state closure policies. In contrast, mental health outpatient visits declined less than other care, and appear less affected by state closure policies. We find substitution to telehealth modalities may have played an important role in mitigating the decline in mental health care utilization. Aggregate trends in outpatient visits show a 40% decline after the first week of March 2020, only a portion of which is attributed to state policy. A rebound starts around mid April that does not appear to be explained by state reopening policy. Despite this rebound, care visits still remain below the pre-epidemic levels in most cases.

Suggested Citation

Ziedan, Engy and Simon, Kosali Ilayperuma and Wing, Coady, Effects of State Covid-19 Closure Policy on Non-Covid-19 Health Care Utilization (July 2020). NBER Working Paper No. w27621, Available at SSRN: https://ssrn.com/abstract=3665892

Engy Ziedan (Contact Author)

Tulane University ( email )

New Orleans, LA 70118
United States

Kosali Ilayperuma Simon

Indiana University Bloomington - School of Public & Environmental Affairs (SPEA) ( email )

1315 East Tenth Street
Bloomington, IN 47405
United States

National Bureau of Economic Research (NBER)

1050 Massachusetts Avenue
Cambridge, MA 02138
United States

Coady Wing

Indiana University ( email )

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