COVID-19 pandemic and healthcare utilization in ovarian cancer patients.

Objectives: We evaluated the impact of the COVID-19 pandemic on healthcare utilization and short-term safety outcomes in ovarian cancer patients. Study design: Retrospective cohort study. Methods: Epithelial ovarian cancer patients (n = 799) diagnosed between 01/01/2017-06/30/2021 at Kaiser Permanente Southern California were included. Pre-pandemic and pandemic periods were defined using 03/04/2020 (implementation of stay-at-home order in California) as the cut-off. Care utilization outcomes included the number of office and virtual visits per person-month, number of CA125, complete blood count, electrolytes, and creatinine tests done for chemotherapy monitoring. Short-term safety outcomes included the number of emergency room (ER) visits and hospitalizations per person-month. Negative binomial models were used to evaluate associations. Results: Overall, 72.7 % and 27.3 % of the patients were diagnosed during the pre-pandemic and pandemic period, respectively. Mean (S.D.) number of office visits per person-month decreased during the pandemic period [0.4 (0.5) vs 0.6 (0.6) in pre-pandemic, p-value < 0.01]. Mean number of virtual visits increased during the pandemic [0.4 (0.7) vs 0.2 (0.3) in pre-pandemic, p-value < 0.01]. The number of virtual visits was twice during the pandemic vs the pre-pandemic period [adjusted-rate ratio (95 %CI): 2.04 (1.54-2.72)]. No differences in ER visits were observed by pandemic periods. Hospitalization rate was lower during the pandemic [adjusted-RR (95 %CI): 0.85 (0.72-1.00)]. In patients who received chemotherapy (n = 684), no differences in chemotherapy monitoring were observed. Conclusions: Despite a shift from office visits to virtual visits during COVID-19, no differences in laboratory monitoring of chemotherapy and no increase in ER visits and hospitalizations were observed in ovarian cancer patients.