2023-05-10

Nothing tells the story of COVID-19 on healthcare systems and offices like its impact on the essence of the business of clinical care: office visits. In this chapter, we will analyze visits before and during the ongoing pandemic. We will discover the time signature of COVID-19 with respect to its effect on visit counts.

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Impact of COVID-19 on office visits

TABLES

Summary Table of Visits and Deficits based on preCOVID year, 2019

Visits deficit: 2022 compared with 2019
clinic CPSP.diff Dent.diff Med.diff Opto.diff Ttl.diff %CPSP.def %Dent.def %Med.def %Opt.def %Ttl.def
Alvin Dental Clinic 0 -5920 0 0 -5920 0 -31.1 0 0 -31.1
Castroville Dental Clinic 0 -3473 -1 0 -3474 0 -43.5 -100 0 -43.6
Castroville Medical Clinic 176 0 1163 0 2166 17.8 0 8.3 0 14.5
Circle Medical Clinic -691 0 1401 0 1914 -23.1 0 5.7 0 7
Circle Optometry Clinic 0 0 1 -1470 -1469 0 0 0 -17.5 -17.5
Gonzales Dental Clinic 0 -210 0 0 -210 0 -5.5 0 0 -5.5
Gonzales Medical Clinic 0 0 1357 0 1432 0 0 36.2 0 38.2
Greenfield Dental Clinic 0 -1501 0 0 -1501 0 -25.6 0 0 -25.6
Greenfield Medical Clinic 838 0 3208 0 4669 57.4 0 29.1 0 37.4
King City CPSP -1 0 0 0 -1 -100 0 0 0 -100
King City Dental Clinic 0 -1953 0 0 -1953 0 -41.5 0 0 -41.5
King City Medical Clinic -78 0 -115 0 243 -10.7 0 -1.6 0 3
Mobile Medical Clinic 0 0 359 0 360 0 0 77.2 0 77.4
Natividad Medical Group SO 0 0 0 0 309 0 0 0 0 0
North Main Dental Clinic 0 -946 0 0 -945 0 -6.3 0 0 -6.3
North Main Medical Clinic 665 0 14 0 1394 0 0 0.1 0 10
Pajaro Dental 0 -606 0 0 -606 0 -14.8 0 0 -14.8
Pajaro Medical 0 0 1571 0 1716 0 0 32.1 0 35.1
Plaza Medical Clinic 0 0 1394 0 1399 0 0 0 0 0
Sanborn Medical Clinic -1249 0 1079 0 2032 -38.5 0 3.4 0 5.7
Seaside Dental Clinic 0 -633 0 0 -633 0 -15.7 0 0 -15.7
Soledad Dental Clinic 0 -466 0 0 -466 0 -8.3 0 0 -8.3
Soledad Medical Clinic 278 0 3427 0 4240 0 0 48.3 0 59.8
Total -62 -15708 14858 -1470 4696 -0.7 -22.4 12.5 -17.5 2.3
Visits deficit: 2021 compared with 2019
clinic CPSP.diff Dent.diff Med.diff Opto.diff Ttl.diff %CPSP.def %Dent.def %Med.def %Opt.def %Ttl.def
Alvin Dental Clinic 0 -4910 0 0 -4910 0 -25.8 0 0 -25.8
Castroville Dental Clinic 0 -2585 -1 0 -2586 0 -32.4 -100 0 -32.4
Castroville Medical Clinic -221 0 -988 0 -609 -22.4 0 -7.1 0 -4.1
Circle Medical Clinic -558 0 1238 0 1717 -18.7 0 5.1 0 6.3
Circle Optometry Clinic 0 0 0 -2242 -2242 0 0 0 -26.7 -26.7
Gonzales Dental Clinic 0 -2379 0 0 -2379 0 -62.3 0 0 -62.3
Gonzales Medical Clinic 0 0 211 0 324 0 0 5.6 0 8.7
Greenfield Dental Clinic 0 -2008 0 0 -2008 0 -34.3 0 0 -34.3
Greenfield Medical Clinic 432 0 330 0 1259 29.6 0 3 0 10.1
King City CPSP -1 0 0 0 -1 -100 0 0 0 -100
King City Dental Clinic 0 -1971 0 0 -1971 0 -41.9 0 0 -41.9
King City Medical Clinic -134 0 -1122 0 -866 -18.3 0 -15.5 0 -10.8
Mobile Medical Clinic 0 0 -135 0 -135 0 0 -29 0 -29
Natividad Medical Group SO 0 0 0 0 169 0 0 0 0 Inf
North Main Dental Clinic 0 -4087 0 0 -4087 0 -27.2 0 0 -27.2
North Main Medical Clinic 329 0 -682 0 332 Inf 0 -4.9 0 2.4
Pajaro Dental 0 -349 0 0 -349 0 -8.5 0 0 -8.5
Pajaro Medical 0 0 1169 0 1261 0 0 23.9 0 25.8
Sanborn Medical Clinic -1373 0 -1620 0 -1137 -42.3 0 -5 0 -3.2
Seaside Dental Clinic 0 -935 0 0 -935 0 -23.3 0 0 -23.3
Soledad Dental Clinic 0 -321 0 0 -321 0 -5.7 0 0 -5.7
Soledad Medical Clinic 114 1 1793 0 2426 Inf Inf 25.3 0 34.2
Total -1412 -19544 193 -2242 -17048 -15 -27.9 0.2 -26.7 -8.2
Visits deficit: 2020 compared with 2019
clinic CPSP.diff Dent.diff Med.diff Opto.diff Ttl.diff %CPSP.def %Dent.def %Med.def %Opt.def %Ttl.def
Alvin Dental Clinic 0 -5640 0 0 -5640 0 -29.6 0 0 -29.6
Castroville Dental Clinic 0 -2462 -1 0 -2463 0 -30.9 -100 0 -30.9
Castroville Medical Clinic 39 0 -379 0 -340 4 0 -2.7 0 -2.3
Circle Medical Clinic -525 0 -108 0 -633 -17.6 0 -0.4 0 -2.3
Circle Optometry Clinic 0 0 0 -3341 -3341 0 0 0 -39.8 -39.8
Gonzales Dental Clinic 0 -1528 0 0 -1528 0 -40 0 0 -40
Gonzales Medical Clinic 0 0 878 0 878 0 0 23.5 0 23.5
Greenfield Dental Clinic 0 -1125 0 0 -1125 0 -19.2 0 0 -19.2
Greenfield Medical Clinic -793 0 255 0 -538 -54.4 0 2.3 0 -4.3
King City CPSP -1 0 0 0 -1 -100 0 0 0 -100
King City Dental Clinic 0 -2014 0 0 -2014 0 -42.8 0 0 -42.8
King City Medical Clinic 79 0 829 0 908 10.8 0 11.4 0 11.4
Mobile Medical Clinic 0 0 124 0 124 0 0 26.7 0 26.7
North Main Dental Clinic 0 -4783 0 0 -4783 0 -31.9 0 0 -31.9
North Main Medical Clinic 0 0 1180 0 1180 0 0 8.4 0 8.4
Pajaro Dental 0 -676 0 0 -676 0 -16.5 0 0 -16.5
Pajaro Medical 0 0 757 0 757 0 0 15.5 0 15.5
Sanborn Medical Clinic -820 1 99 0 -720 -25.3 Inf 0.3 0 -2
Seaside Dental Clinic 0 -1119 0 0 -1119 0 -27.8 0 0 -27.8
Soledad Dental Clinic 0 -1580 0 0 -1580 0 -28 0 0 -28
Soledad Medical Clinic 0 0 -708 0 -708 0 0 -10 0 -10
Total -2021 -20926 2926 -3341 -23362 -21.5 -29.8 2.5 -39.8 -11.3

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General

TIME SERIES Visits: year-to-date comparisons for 2019 and 2020

Visits 2019

Visits: year-to-date comparisons for 2019 and 2020 & beyond

2019 visit count

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Visits 2020

2020 visit count

Telehealth Overlay

cmp.vst.tlhlt<-cbind("prcnt_telehealth_visits"=ts.pcv.prcnt.whle, "Visits_in_2020..." =cmbo.vzt.ts)
roll.vst_tlhlt<-dygraph(cmp.vst.tlhlt, main= "Overlaying CSVS all-visit trend with telehealth visits", ylab = "visits in 2020")%>%
  dySeries("prcnt_telehealth_visits", axis = 'y2')%>%
  dyAxis("y2", label = "% telehealth visits")%>%
  dyRoller(showRoller = TRUE, rollPeriod = 7)%>%
  dyRangeSelector(dateWindow =c("2020-02-01", "2021-12-31"), height = 20)%>%
  dyEvent(c("2020-07-04", "2020-09-07", "2020-11-26", "2020-12-25"), c("Independence Day", "Labor Day", "Thanksgiving Day", "Christmas Day"), 
          labelLoc = "bottom")%>%
  dyShading(from = "2020-3-2", to = "2020-7-15")%>%
  dyOptions(drawPoints = FALSE, pointSize = 2)%>%
  dyHighlight(highlightSeriesOpts = list(strokeWidth = 3))
roll.vst_tlhlt

Visits for years 2019 through 2020 & beyond

Visits: year-to-date comparisons for 2019 and 2020 & beyond

The roll(ing) mean is similar to moving averages. You may change the units of the roll by typing into the box in the lower left hand corner and clicking on . For example, weekly moving average takes 7 (for 7 day / week). For pure trending, use higher units which smoothen out the curve. If the input is zero (0), the resulting graph represents un-averaged daily counts.

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Roll-mean of visits

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Medical Service

Medical –raw

Medical – Rolling Mean

Dental Service

Dental – RAW

Use the slide bars to dynamically “zoom in” periods of interest, down to specific calendar dates.

Dental – Rolling Mean

Optometry Service

Optometry – RAW

Optometry – Rolling mean

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Prenatal (CPSP) Service

CPSP – RAW

Use the slide bars to dynamically “zoom in” periods of interest, down to specific calendar dates.

CPSP – Rolling mean

Use the slide bars to dynamically “zoom in” periods of interest, down to specific calendar dates.

Categories & Aspects

Click on the header tabs below for the graphs.

Column

CHDP visits

Visits

CHDP: Roll Mean Visit

roll mean of visits

Self Pay visits

visits

Self Pay: Roll mean visits

roll mean of visits

Managed Medi-Cal visits

visits

Managed Medi-Cal: Roll mean visits

roll mean of visits

Medicare visits

visits

Medicare: Roll mean visits

roll mean of visits

Blue Cross Blue Shield visits

visits

Blue Cross/Shield: Roll mean visits

roll mean of visits

By Practice type at Office-level examples

Dental Offices

roll mean of visits

Medical Offices

roll mean of visits