Working Paper: NBER ID: w28131
Authors: Jonathan H. Cantor; Neeraj Sood; Dena Bravata; Megan Pera; Christopher M. Whaley
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 and hospitals. However, controlling for county-level exposure to the COVID-19 pandemic 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.
Keywords: COVID-19; healthcare utilization; shelter-in-place policies; medical claims; telemedicine
JEL Codes: I01; I12; I18
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| SIP policies (Z28) | reductions in preventive care (I14) |
| SIP policies (Z28) | reductions in elective care (I10) |
| SIP policies (Z28) | reductions in weekly visits to physician offices and hospitals (I11) |
| COVID-19 exposure (I14) | reductions in healthcare utilization (I18) |
| SIP policies (Z28) | reductions in colonoscopies (H23) |
| SIP policies (Z28) | reductions in immunizations (I19) |
| SIP policies (Z28) | minimal impact on non-elective care (I10) |