CHI report highlights missed care during pandemic, urges providers to reconnect with patients


Eli Kirshbaum


A report released this month by the Colorado Health Institute (CHI) illustrates the magnitude of missed medical care in Colorado during the pandemic and offers recommendations for addressing this offput care. 

Using medical record data from the Colorado Health Observation Regional Data Service (CHORDS), CHI examined the volume of patient visits among approximately 1.5 million Coloradans and compared it with the same data from 2019. 12 of the 14 providers in the Front Range in CHORDS’s network contributed their data to the study. It included both in-person and virtual visits.


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Overall health care use in Colorado was 25% lower between Mar. 2020 and Dec. 2020 than it was during the same period in 2019, according to CHI.

The image below shows how rapidly medical visits fell in Colorado at the beginning of the pandemic.

Image: Colorado Health Institute


The report says Coloradans with chronic diseases, depression, and individuals over 65 missed the most care. Visits for chronic conditions like asthma and diabetes among Coloradans decreased by an average of 38% across all age groups between 2019 and 2020. The report cites a national survey that revealed 76% of adults who skipped care during the pandemic had at least one chronic condition.

Consequences of missed care for chronic conditions include worsened diabetes, hypertension, and obesity. Some patients also ran out of medications, according to the report.

Visits for Coloradans with cancer between March and December of 2020 were 22% lower than they were during the same period in 2019. Chemotherapy and radiation treatments were delayed, and in some instances, cancer treatment periods were accelerated or changed. 

Preventive cancer screenings also decreased. Preventive tests and screenings in general declined by over 25% in 2020 compared to 2019, according to the report. Missed tests and screenings were highest among older Coloradans.

See below a graph illustrating the level of missed diagnostic and screening tests in 2020.


Image: Colorado Health Institute


When the need for mental health services was higher than ever during the pandemic, behavioral health visits declined considerably. Services related to depression decreased by 33% and services related to anxiety decreased by 23%. This is despite a rise in telemedicine use.

Emergency department visits among Coloradans decreased by around 25%. Patients also often delayed care for serious acute health issues like heart attacks, strokes, and appendicitis, which require prompt treatment in order to fully recover.

The report highlighted some recommendations for how Colorado can address the significant number of patients who missed care during the pandemic. One potential solution is for providers to reach out to patients with chronic diseases to check their health status and encourage them to seek care if they haven’t already done so.

Another recommendation from the report is for parents to ensure their children are immunized for vaccine-treatable diseases. CHI also recommends that Coloradans, when applicable, should schedule regular screenings for colorectal cancer, breast cancer, and other preventive screenings they might have missed.