ArticleHealth services research2025
Integrated health systems and medical care quality during the COVID-19 pandemic.
Article in Health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Integrated health systems and medical care quality during the COVID-19 pandemic.Health services research · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
objectiveTo examine differences between patients treated in integrated systems of care and patients treated outside of such systems during the COVID pandemic in the use of primary and preventive care, emergency services, inpatient services, and mortality. DATA SOURCES AND STUDY
settingData are used from all enrollees in traditional Medicare aged 66 and older. STUDY
designDifference-in-differences estimates are calculated from the pre-COVID time period (January 2019-February 2020) to the initial COVID time period (March-May 2020) and the ongoing COVID time period (June 2020-December 2021) for patients treated by primary care physicians working in a health system versus not, and by the type of health system. DATA COLLECTION/EXTRACTION
methodsMedicare claims data are used to measure monthly claims for office and telehealth visits, mammography, colon cancer screening, inpatient/emergency department visits, and death. Patients are assigned to primary care physicians using common algorithms. Physician membership in a health system is determined from a previously generated dataset. PRINCIPAL
findingsRelative to the pre-COVID period, patients treated in health systems fared no better in maintaining primary care access than patients treated outside of such systems (DID estimate on receipt of office care or telehealth visit = -4%; p < 0.001). In the ongoing COVID time period, non-COVID mortality rose by less in health systems (DID estimate = -0.9%; p < 0.001) and health system patients experienced a greater decline in the use of the emergency department (DID estimate = -1.2%; p < 0.001) and emergency/urgent inpatient care for non-COVID conditions less (DID estimate = -0.7%; p < 0.001).
conclusionHealth systems were associated with reduced occurrence of death and adverse medical events, although the effect magnitudes are modest. This reduction appears unrelated to the use of primary care and should be considered in the context of our evolving understanding of the advantages and disadvantages of health systems.
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What OpenQuestion holds
Registered trials
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