4.4 Article

Disruptions in preventive care: Mammograms during the COVID-19 pandemic

Journal

HEALTH SERVICES RESEARCH
Volume 56, Issue 1, Pages 95-101

Publisher

WILEY
DOI: 10.1111/1475-6773.13596

Keywords

COVID-19; early detection of cancer; mammography; missed diagnosis; preventive medicine

Funding

  1. National Institutes of Health [T32-5T32HS26116]

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The provision of mammograms has been significantly disrupted due to the COVID-19 pandemic, with a sharp decline in the volume of screening and diagnostic mammograms, although they gradually rebounded in the following weeks.
Objective To measure the extent to which the provision of mammograms was impacted by the COVID-19 pandemic and surrounding guidelines. Data Sources De-identified summary data derived from medical claims and eligibility files were provided by Independence Blue Cross for women receiving mammograms. Study Design We used a difference-in-differences approach to characterize the change in mammograms performed over time and a queueing formula to estimate the time to clear the queue of missed mammograms. Data Collection We used data from the first 30 weeks of each year from 2018 to 2020. Principal Findings Over the 20 weeks following March 11, 2020, the volume of screening mammograms and diagnostic mammograms fell by 58% and 38% of expected levels, on average. Lowest volumes were observed in week 15 (April 8 to 14), when screening and diagnostic mammograms fell by 99% and 74%, respectively. Volumes began to rebound in week 19 (May), with diagnostic mammograms reaching levels to similar to previous years' and screening mammograms remaining 14% below expectations. We estimate it will take a minimum of 22 weeks to clear the queue of missed mammograms in our study sample. Conclusions The provision of mammograms has been significantly disrupted due to the COVID-19 pandemic.

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