Healthcare News of Note: Is a public health crisis looming for the generation born during the pandemic?

• Infants born during the pandemic, regardless of maternal SARS-CoV-2 status, scored significantly lower on the gross motor, fine motor and personal-social subdomains of the Ages & Stages Questionnaire, 3rd Edition when compared with a cohort born pre-pandemic at one hospital.
• Opioids were prescribed at discharge during fewer emergency department (ED) visits in 2019-20, compared with 2017-18.
• The percentage of people who have had COVID and currently report long-COVID symptoms declined between June 2022 and January 2023.

Over the past few weeks, I have found these industry news stories that should be of interest to healthcare finance professionals.    

1. Further investigation is necessary to study a potential public health crisis for infants born during the pandemic

A study published Jan. 4 in JAMA Pediatrics shows that “infants born during the pandemic, regardless of maternal SARS-CoV-2 status, scored significantly lower on the gross motor, fine motor, and personal-social subdomains” of the Ages & Stages Questionnaire, 3rd Edition, “compared with a historical cohort of infants” born at Columbia University Irving Medical Center in New York City.

“These findings suggest that birth during the COVID-19 pandemic, but not maternal SARS-CoV-2 infection, is associated with differences in neurodevelopment at age 6 months,” wrote the authors.

“COVID-19-related stress should be considered as a potential underlying mechanism” for the cited neurodevelopmental delays, according to the study. The authors cited job loss and food insecurity among the specific possible stressors.

The ASQ3 developmental screening tool was used by the study’s researchers between Oct. 7, 2020, and June 17, 2021, to assess a pandemic cohort of 255 babies and between May 24, 2018, and July 22, 2020, for the historical cohort of 62 babies.

Other significant findings

Study authors noted the following:

• Sensitivity analyses excluding 15 infants in the historical cohort who had postnatal exposure to the pandemic environment before being assessed did not alter the main findings, suggesting a relatively greater association between neurodevelopment and in-utero exposure to the pandemic than postnatal pandemic exposure.
• Early gestation at the peak of the pandemic in New York City was associated with the lowest scores on these subdomains compared with the historic controls.

“Taken together, these findings suggest the potential for a significant public health crisis for the generation born during the COVID-19 pandemic, necessitating further investigation,” wrote the authors.

2. Fewer opioids were prescribed upon discharge from an emergency department in 2017-20

Emergency department (ED) personnel wrote fewer opioid prescriptions for patients being discharged during a three-year time span, according to data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) 2017-20, stated a recent Data Brief by the Centers for Disease Control & Prevention’s National Center for Health Statistics.

Although study authors acknowledge that “opioids may be an effective treatment for chronic and acute pain when properly used,” they also wrote that per an Annals of Emergency Medicine article published in 2015, “receiving an opioid prescription in the emergency department (ED) has been identified as a potential risk factor for long-term use.”

Other key findings in the report based on the NHAMCS data include:

• Opioids were prescribed at discharge for 36.4 ED visits per 1,000 adults in 2019-20, compared with 50.5 ED visits in 2017-18.
• For both men and women, the rate of ED visits with an opioid prescribed at discharge was lower in 2019-20 than in 2017-18 (see the chart below for more detail).
• The percentage of ED visits with an opioid prescribed at discharge decreased from 12.2% in 2017-18 to 8.1% in 2019-20.
• Among non-Hispanic White and non-Hispanic Black people, the percentage of ED visits with an opioid prescribed at discharge decreased in 2019-20 when compared with 2017-18, while the observed decrease for Hispanic people was not significant.
• Across all primary expected sources of payment, the percentage of ED visits with opioids prescribed at discharge decreased in 2019-20 compared with 2017-18.

Rate of emergency department visits by adults with opioids prescribed at discharge, by sex: United States, 2017-20

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3.  While long-COVID data shows decline in US cases, many still struggle with limitations in its wake

“COVID cases, deaths, and hospitalizations have stabilized after a small surge around the holidays,” as of Jan. 25, according to Centers for Disease Control and Prevention (CDC) data, stated a Jan. 26 Kaiser Family Foundation (KFF) report by Alice Burns.

“There is still a great deal of uncertainty about long COVID and whether there will be increased long COVID cases following the holiday bump,” wrote the author, who shared the latest data from the CDC’s Household Pulse Survey.

The data showed, in part:

• The percentage of people who have had COVID and currently report long-COVID symptoms declined from 19% in June 2022 to 11% in January 2023.
• Among people with long COVID, 79% report having limitations to their day-to-day activities and 27% characterize the limitations as significant.
• Although a smaller percentage of people with COVID are reporting long COVID, 5% of the adult population is struggling with activity limitations from long COVID.

Although this report did not discuss what the findings could mean for insurance coverage or the healthcare industry, a Healthcare News of Note blog post from August 2022 reported that “long COVID may affect 10 million to 33 million working-age adults in the United States, and it could significantly change healthcare coverage for many.”

HFMA bonus content

Read the February issue of hfm magazine, including the cover story, “Norton Healthcare and other health systems are making big moves to reduce health inequities,” the Expert Reviewed piece “Point-of-service collection goes better if the right strategies and tactics are employed,” and HFMA President and CEO Joe Fifer’s column, “Why finance leaders require the courage to lead.”