Publication date: Jun 24, 2026
The COVID-19 pandemic substantially disrupted healthcare utilization across clinical conditions, populations, and care settings. Consistent and equitable access to care is essential to mitigate the long-term consequences of COVID-19, particularly among individuals with pre-existing conditions. While prior studies have documented broad patterns in healthcare use during the pandemic, limited evidence exists on how utilization shifts before and after a COVID-19 diagnosis, particularly across specific diseases, encounter types, and sociodemographic subgroups. We conducted a matched retrospective cohort study using electronic health record data from MedStar Health between March 25, 2019, and June 30, 2021. A difference-in-differences design was used to compare changes in health care utilization between adult patients who tested positive for COVID-19 (exposure group) and those who tested negative (comparison group), across the 6-month periods before and after testing. Outcomes included encounters across outpatient, inpatient, emergency department, and virtual settings, overall and stratified by pre-existing conditions (heart failure, diabetes mellitus, kidney disease, malignant neoplasm, hypothyroidism, hyperthyroidism, anxiety disorder, depressive disorder, and drug poisoning/overdose), while accounting for demographic characteristics (sex, age, race/ethnicity, insurance type, state of residence) and census tract-level socioeconomic indicators (median household income, educational attainment, and poverty/food access). To estimate the absolute burden of health care utilization associated with COVID-19, we converted DiD rate ratios into excess encounters per 1,000 individuals in the exposed group. COVID-19 exposure was associated with a 4% overall reduction in health care utilization during the post-COVID period (RR = 0. 96, p
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Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | COVID-19 |
| disease | MESH | included |
| disease | MESH | emergency |
| disease | MESH | heart failure |
| disease | MESH | diabetes mellitus |
| disease | MESH | kidney disease |
| disease | MESH | malignant neoplasm |
| disease | MESH | hypothyroidism |
| disease | MESH | hyperthyroidism |
| disease | MESH | poisoning |
| pathway | REACTOME | Reproduction |
| disease | MESH | Oak |
| disease | MESH | Park |
| disease | MESH | anxiety disorder |
| disease | MESH | Chronic conditions |