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The impact of the COVID-19 pandemic and policy response on health care utilization: Evidence from county-level medical claims and cellphone data

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  • Cantor, Jonathan
  • Sood, Neeraj
  • Bravata, Dena M.
  • Pera, Megan
  • Whaley, Christopher
Abstract
The COVID-19 pandemic has forced federal, state, and local policymakers to respond by legislating, enacting, and enforcing social distancing policies. However, the impact of these policies on healthcare utilization in the United States has been largely unexplored. We examine the impact of county-level shelter in place ordinances on healthcare utilization using two unique datasets—employer-sponsored insurance for over 6 million people in the US and cell phone location data. We find that introduction of these policies was associated with reductions in the use of preventive care, elective care, and the number of weekly visits to physician offices, hospitals and other health care-related industries. However, controlling for county-level exposure to the COVID-19 pandemic as a way to account for the endogenous nature of policy implementation reduces the impact of these policies. Our results imply that while social distancing policies do lead to reductions in healthcare utilization, much of these reductions would have occurred even in the absence of these policies.

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  • Cantor, Jonathan & Sood, Neeraj & Bravata, Dena M. & Pera, Megan & Whaley, Christopher, 2022. "The impact of the COVID-19 pandemic and policy response on health care utilization: Evidence from county-level medical claims and cellphone data," Journal of Health Economics, Elsevier, vol. 82(C).
    • Handle: RePEc:eee:jhecon:v:82:y:2022:i:c:s0167629622000017
    DOI: 10.1016/j.jhealeco.2022.102581
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    2. Ge Bai & Daniel Jiménez & Phillip Phan & Luis E. Quintero & Alessandro Rebucci & Xian Sun, 2021. "The Financial Fragility of For-profit Hospitals: Evidence from the COVID-19 Pandemic," NBER Working Papers 29388, National Bureau of Economic Research, Inc.
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    4. Erkmen G. Aslim & Wei Fu & Chia-Lun Liu & Erdal Tekin, 2022. "Vaccination Policy, Delayed Care, and Health Expenditures," NBER Working Papers 30139, National Bureau of Economic Research, Inc.
    5. Anneliese N. Luck & Irma T. Elo & Samuel H. Preston & Eugenio Paglino & Katherine Hempstead & Andrew C. Stokes, 2023. "COVID-19 and All-Cause Mortality by Race, Ethnicity, and Age Across Five Periods of the Pandemic in the United States," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 42(4), pages 1-29, August.
    6. Virat Agrawal & Jonathan H. Cantor & Neeraj Sood & Christopher M. Whaley, 2021. "The Impact of the COVID-19 Pandemic and Policy Responses on Excess Mortality," NBER Working Papers 28930, National Bureau of Economic Research, Inc.
    7. Cronin, Christopher J. & Evans, William N., 2022. "Nursing home quality, COVID-19 deaths, and excess mortality," Journal of Health Economics, Elsevier, vol. 82(C).
    8. Feng Huang & Hong Liu, 2023. "The impact of the COVID‐19 pandemic and related policy responses on non‐COVID‐19 healthcare utilization in China," Health Economics, John Wiley & Sons, Ltd., vol. 32(3), pages 620-638, March.
    9. Kattih, Nour & Mansour, Fady, 2024. "The impact of the COVID pandemic on health, healthcare utilization, and healthcare spending," Research in Economics, Elsevier, vol. 78(2).
    10. Chen, Zhuo & Li, Pengfei & Liao, Li & Liu, Lu & Wang, Zhengwei, 2024. "Assessing and addressing the coronavirus-induced economic crisis: Evidence from 1.5 billion sales invoices," China Economic Review, Elsevier, vol. 85(C).
    11. Lauren Gilbert & Susan Parker & Lauren Schechter, 2024. "The impact of the COVID-19 pandemic on treatment for domestic violence injuries: evidence from medical claims," Review of Economics of the Household, Springer, vol. 22(2), pages 535-562, June.
    12. Dena Bravata & Jonathan H. Cantor & Neeraj Sood & Christopher M. Whaley, 2021. "Back to School: The Effect of School Visits During COVID-19 on COVID-19 Transmission," NBER Working Papers 28645, National Bureau of Economic Research, Inc.
    13. Monteic A. Sizer & Dependra Bhatta & Binod Acharya & Krishna P. Paudel, 2022. "Determinants of Telehealth Service Use among Mental Health Patients: A Case of Rural Louisiana," IJERPH, MDPI, vol. 19(11), pages 1-11, June.
    14. Bryan C. McCannon & Mark Wilson, 2023. "Mask Mandates Increased COVID-19 Deaths in Kansas," Journal of Private Enterprise, The Association of Private Enterprise Education, vol. 38(Winter 20), pages 29-54.
    15. Wolfgang Frimmel & Gerald J. Pruckner, 2024. "The COVID-19 pandemic and health care utilization: Evidence from Austrian register data," Economics working papers 2024-03, Department of Economics, Johannes Kepler University Linz, Austria.
    16. Shooshan Danagoulian & Thomas A. Wilk, 2022. "Locking out prevention: Dental care in the midst of a pandemic," Health Economics, John Wiley & Sons, Ltd., vol. 31(9), pages 1973-1992, September.
    17. Yu shin Park & Soo Young Kim & Eun-Cheol Park & Sung-In Jang, 2022. "Screening for Diabetes Complications during the COVID-19 Outbreak in South Korea," IJERPH, MDPI, vol. 19(9), pages 1-12, April.

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    More about this item

    Keywords

    COVID-19 pandemic; Health care utilization; Telehealth; Shelter-in-place policies;
    All these keywords.

    JEL classification:

    • I0 - Health, Education, and Welfare - - General
    • I1 - Health, Education, and Welfare - - Health
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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