EYEWIRE.NEWS: ONGOING COVID-19 COVERAGE
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No Benefit of Hydroxychloroquine Seen in Observational Study
In an observational study of patients hospitalized due to COVID-19, administration of hydroxychloroquine “was not associated with either a greatly lowered or an increased risk of the composite end point of intubation or death,” according to researchers at two New York hospitals.1
The study examined the association between hydroxychloroquine use and intubation or death in 1,446 consecutive patients hospitalized with COVID-19. Patients who were intubated, died, or discharged within 24 hours after presentation were excluded from analysis. Of the remaining 1,376 patients, 811 (58.9%) received hydroxychloroquine. Those who received the drug were more severely ill at baseline than those who did not receive it.
With a median follow-up of 22.5 days, 346 patients either died or were intubated—the composite endpoint of the study. No significant association was found between hydroxychloroquine use and intubation or death (hazard ratio, 1.04; 95% confidence interval, 0.82–1.32).
“Randomized, controlled trials of hydroxychloroquine in patients with COVID-19 are needed,” the authors, from New York-Presbyterian Hospital and Columbia University’s Irving Medical Center in New York, concluded. The study was funded by the US National Institutes of Health.
1. Geleris J, Sun Y, Platt J, et al. Observational study of hydroxychloroquine in hospitalized patients with Covid-19 [published online ahead of print May 7, 2020]. N Engl J Med.
CMS Adjusts Telehealth Rules During COVID-19 Crisis
Government agencies have broadened access to Medicare telehealth services during the pandemic crisis by increasing the flexibility of certain rules, so that beneficiaries can receive more services without the need to travel to a health care facility. The changes, initiated by the Centers for Medicare and Medicaid Services (CMS) and by the Department of Health and Human Services Office of Civil Rights, have included relaxing federal privacy regulations and expanding payment policies.
The aim of the changes is to keep beneficiaries healthy by increasing their access to benefits while also limiting the community spread of the virus by reducing travel to health facilities.
With the emergence of the SARS-CoV-2 virus, “there is an urgency to expand the use of technology to help people who need routine care, and keep vulnerable beneficiaries and beneficiaries with mild symptoms in their homes while maintaining access to the care they need,” CMS said in announcing the changes in March.
Under the waiver, Medicare can pay for office, hospital, and other visits furnished via telehealth across the country, including in patients’ places of residence. Previously, reimbursement for telehealth services was limited to its use in reaching patients in rural areas or when the patient was in a designated health facility. The changes also allow health care providers to reduce or waive cost-sharing for telehealth visits paid for by federal programs.
Analysis: Ophthalmology Lost More Patient Volume Due to COVID-19 Than Any Other Specialty
Compared with figures from 2019, ophthalmology lost more patient volume during March and April of this year than any other medical specialty, according to an analysis of data from more than 2 million patient visits.
The analysis, released in May by Strata Decision Technology, found that ophthalmology lost 81% of patient volume, comparing 2-week volumes in March and April 2020 versus the same periods in 2019. The firm also noted a 97% reduction in cataract surgery volume—the largest reduction of any surgical procedure—and an 88% reduction in glaucoma procedures.
The analysis included data from 228 hospitals in 51 health care delivery systems in 40 states, with varying rates of COVID-19 cases among the hospitals. Across all service lines and in every region of the country, there was an average decrease of 54.5% in the number of unique patients who sought care in a hospital setting, the analysis found. Much of the drop in encounters is due to the cancelation of elective surgeries during the pandemic, according to Strata.
Strata released the data in conjunction with the launch of its National Patient and Procedure Volume Tracker, which will be updated weekly and is available free of charge.1
1. National Patient and Procedure Volume Tracker. Strata Decision Technology. May 11, 2020. https://www.stratadecision.com/National-Patient-and-Procedure-Volume-Tracker/. Accessed May 20, 2020.