Preventive Service Usage and New Chronic Disease Diagnoses: Using PCORnet Data to Identify Emerging Trends, United...

Area of Science:

• Public Health
• Health Services Research
• Epidemiology

Background:

• The COVID-19 pandemic significantly disrupted healthcare access and delivery.
• Data modernization is crucial for strengthening public health surveillance capacity.
• Assessing trends in preventive services and chronic disease diagnoses is vital.

Purpose of the Study:

• To examine trends in the utilization of preventive health services.
• To describe new diagnoses of chronic diseases.
• To quantify health debt incurred during the pandemic.

Main Methods:

• Cross-sectional study using electronic health records (EHR) from a large national research network (PCORnet).
• Analysis of 8 preventive services and 9 chronic diseases in US adults (aged 21-79) from 2018-2022.
• Joinpoint regression for trend analysis and calculation of health debt by comparing 2020-2022 to prepandemic levels.

Main Results:

• Use of some preventive services (e.g., hemoglobin A1c, lung CT) increased, while others (e.g., colonoscopies) declined.
• Most new chronic disease diagnoses remained stable, though some cancers declined.
• A significant health debt was observed in 2020 for services and diagnoses, with partial rebound in subsequent years.

Conclusions:

• Preventive service use and chronic disease diagnoses declined in 2020, leading to health debt, followed by a rebound.
• Persistent health debt indicates lingering impacts of pandemic-related disruptions.
• EHR data augmentation offers opportunities to enhance traditional public health surveillance methods.