Frequency and factors associated with foregone and delayed medical care due to COVID-19 among nonelderly US adults from August to December 2020.
delayed care
foregone care
healthcare access
pandemic
Journal
Journal of evaluation in clinical practice
ISSN: 1365-2753
Titre abrégé: J Eval Clin Pract
Pays: England
ID NLM: 9609066
Informations de publication
Date de publication:
02 2022
02 2022
Historique:
revised:
02
11
2021
received:
26
08
2021
accepted:
30
11
2021
pubmed:
16
12
2021
medline:
20
1
2022
entrez:
15
12
2021
Statut:
ppublish
Résumé
To estimate the frequency and factors associated with foregone and delayed medical care attributed to the COVID-19 pandemic among nonelderly adults from August to December 2020 in the United States. We used three survey waves from the Urban Institute's Household Pulse Survey (HPS) collected between August 19-31, October 14-26 and December 9-21. The final sample included 155,825 nonelderly (18-64) respondents representing 135,835,598 million individuals in the United States. We used two multivariable logistic regressions to estimate the association between respondents' characteristics and foregone and delayed care. The frequency of foregone and delayed medical care was 26.9% and 35.9%, respectively. Around 60% of respondents reported difficulties in paying for usual household expenses in the last 7 days. More than half reported several days of mental health issues. The regression results indicated that foregone or delayed care were significantly associated with difficulties in paying usual household expenses (p < 0.001), worse self-reported health status (p < 0.001), increased mental health problems (p < 0.001), Veterans Affairs (p <0.001) or Medicaid (p = 0.003) coverage compared to private healthcare coverage, and older age groups. Individuals who participated in the latter two waves of the survey (October, December) were less likely to report foregone and delayed care compared to those who participated in Wave 1 (August). Overall, the frequency of foregone and delayed medical care remained high from August to December 2020 among nonelderly US adults. Our findings highlight that pandemic-induced access barriers are major drivers of reduced healthcare provision during the second half of the pandemic and highlight the need for policies to support patients in seeking timely care.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
33-42Informations de copyright
© 2021 John Wiley & Sons Ltd.
Références
Sarac NJ, Sarac BA, Schoenbrunner AR, et al. A review of state guidelines for elective orthopaedic proceduresduring the COVID-19 outbreak. J Bone Joint Surg Am. 2020;102(11):942-945.
Hollander JE, Carr BG. Virtually perfect? telemedicine for COVID-19. N Engl J Med. 2020;382(18):1679-1681. doi:10.1056/NEJMp2003539
Verma S. Early impact of CMS expansion of Medicare telehealth during COVID-19. Health Affairs Blog. 2020;15:15.
Barnett ML, Ray KN, Souza J, Mehrotra A. Trends in telemedicine use in a large commercially insured population, 2005-2017. JAMA. 2018;320(20):2147-2149.
Anderson KE, McGinty EE, Presskreischer R, Barry CL. Reports of forgone medical care among US adults during the initial phase of the COVID-19 pandemic. JAMA Netw Openn. 2021;4(1):e2034882.
Findling MG, Blendon RJ, Benson JM. Delayed care with harmful health consequences-reported experiences from national surveys during Coronavirus Disease 2019. JAMA Health Forum. 2020;1(12):e201463.
United States Census Bureau. Household Pulse Survey Data Tables. Accessed January 31, 2021. https://www.census.gov/programs-surveys/household-pulse-survey/data.html
Giannouchos TV, Biskupiak J, Moss MJ, Brixner D, Andreyeva E, Ukert B. Trends in outpatient emergency department visits during the COVID-19 pandemic at a large, urban, academic hospital system. Am J Emerg Med. 2020 Dec 9;40:20-26.
Patel SY, Mehrotra A, Huskamp HA, et al. Trends in Outpatient Care Delivery and Telemedicine during the COVID-19 Pandemic in the US. JAMA Intern Med. 2020.
Litchman GH, Rigel DS. The immediate impact of COVID-19 on US dermatology practices. J Am Acad Dermatol. 2020;83(2):685-686.
Jeffery MM, D'onofrio G, Paek H, et al. Trends in emergency department visits and hospital admissions in health care systems in 5 states in the first months of the CoViD-19 pandemic in the US. JAMA Intern Med. 2020;180(10):1328-1333.
Baum A, Schwartz MD. Admissions to veterans affairs hospitals for emergency conditions during the COVID-19 pandemic. JAMA. 2020;324(1):96-99.
Hartnett KP, Kite-Powell A, DeVies J, et al. Impact of the COVID-19 pandemic on Emergency department Visits-United States, January 1, 2019-May 30, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(23):699-704.
Boserup B, McKenney M, Elkbuli A. The impact of the COVID-19 pandemic on emergency department visits and patient safety in the United States. Am J Emerg Med. 2020;38(9):1732-1736.
DiFazio LT, Curran T, Bilaniuk JW, et al. The impact of the COVID-19 pandemic on hospital admissions for trauma and acute care surgery. Am Surg. 2020;86(8):901-903.
Birkmeyer JD, Barnato A, Birkmeyer N, Bessler R, Skinner J. The Impact of the COVID-19 pandemic on hospital admissions in the United States: study examines trends in US hospital admissions during the COVID-19 pandemic. Health Aff. 2020;39(11):2010-2017.
Solomon MD, McNulty EJ, Rana JS, et al. The COVID-19 pandemic and the incidence of acute myocardial infarction. N Engl J Med. 2020;383(7):691-693.
Bhatt AS, Moscone A, McElrath EE, et al. Fewer hospitalizations for acute cardiovascular conditions during the COVID-19 pandemic. J Am Coll Cardiol. 2020;76(3):280-288.
Barnett ML, Hu L, Martin T, Grabowski DC. Mortality, admissions, and patient census at SNFs in 3 US cities during the COVID-19 pandemic. JAMA. 2020;324(5):507-509.
Bilinski A, Emanuel EJ. COVID-19 and excess all-cause mortality in the US and 18 comparison countries. JAMA. 2020;324(20):2100-2102.
Fitzpatrick KM, Harris C, Drawve G. Fear of COVID-19 and the mental health consequences in America. Psychol Trauma. 2020;12(S1):S17-S21.
Holingue C, Badillo-Goicoechea E, Riehm KE, et al. Mental distress during the COVID-19 pandemic among US adults without a pre-existing mental health condition: findings from American trend panel survey. Prev Med. 2020;139:106231.
Wong LE, Hawkins JE, Langness S, et al. Where are all the patients? Addressing Covid-19 fear to encourage sick patients to seek emergency care. New Eng J Med Catalyst Innov Care Deliv. 2020:1-12.
Allen EM, Call KT, Beebe TJ, McAlpine DD, Johnson PJ. Barriers to care and healthcare utilization among the publicly insured. Med Care. 2017;55(3):207-214.
Kullgren JT, Galbraith AA, Hinrichsen VL, et al. Health care use and decision making among lower-income families in high-deductible health plans. Arch Intern Med. 2010;170(21):1918-1925.
Urban Institute. Census Pulse Public Use Files: Questionnaire Two. https://datacatalog.urban.org/dataset/census-pulse-public-use-files-questionnaire-two. Data originally sourced from https://www.census.gov/programs-surveys/household-pulse-survey/datasets.html, developed at the Urban Institute, and made available under the ODC-BY 1.0 Attribution License. 2020.
Kaiser Family Foundation. Population: Demographics and the Economy Indicators. Accessed January 27, 2021. https://www.kff.org/state-category/demographics-and-the-economy/population/
Thomas AW, Valero-Elizondo J, Khera R, et al. Foregone and delayed medical care is associated with increased health care costs and utilization among heart failure patients in the United States. Circulation. 2019;140(Suppl_1):A13991.
Kaiser Family Foundation. Health Costs: Americans' Challenges with Health Care Costs. Accessed February 3, 2021. https://www.kff.org/health-costs/issue-brief/data-note-americans-challenges-health-care-costs/
National Institute of Mental Health. Statistics: Mental Illness. Accessed February 2, 2021. https://www.nimh.nih.gov/health/statistics/mental-illness.shtml
Centers of Disease Control and Prevention. National Center of Health Statistics. Diseases and Conditions: Mental Health. Accessed February 2, 2021. https://www.cdc.gov/nchs/fastats/mental-health.htm
Zhao G, Okoro CA, Hsia J, Town M. Peer reviewed: self-perceived poor/fair health, frequent mental distress, and health insurance status among working-aged US adults. Prev Chronic Dis. 2018;15:170523.
Warren Andersen S, Blot WJ, Lipworth L, Steinwandel M, Murff HJ, Zheng W. Association of race and socioeconomic status with colorectal cancer screening, colorectal cancer risk, and mortality in Southern US adults. JAMA Netw Open. 2019;2(12):e1917995.
Villatoro AP, Mays VM, Ponce NA, Aneshensel CS. Perceived need for mental health care: The intersection of race, ethnicity, gender, and socioeconomic status. Society and Mental Health. 2018;8(1):1-24.
Diamant AL, Hays RD, Morales LS, et al. Delays and unmet need for health care among adult primary care patients in a restructured urban public health system. Am J Public Health. 2004;94(5):783-789.
Allen H, Wright BJ, Baicker K. New medicaid enrollees in Oregon report health care successes and challenges. Health Aff. 2014;33(2):292-299.
Cheung PT, Wiler JL, Lowe RA, Ginde AA. National study of barriers to timely primary care and emergency department utilization among Medicaid beneficiaries. Ann Emerg Med. 2012;60(1):4-10.
Hoffman DA. Increasing access to care: telehealth during COVID-19. J Law Biosci. 2020;7(1):a043.
DeJong C, Katz MH, Covinsky K. Deferral of care for serious non-COVID-19 conditions: a hidden harm of COVID-19. JAMA Intern Med. 2021;181(2):274.
Tipirneni R, Politi MC, Kullgren JT, Kieffer EC, Goold SD, Scherer AM. Association between health insurance literacy and avoidance of health care services owing to cost. JAMA Netw Open. 2018;1(7):e184796.
Asch DA. Opening hospitals to more patients during the COVID-19 pandemic-making it safe and making it feel safe. JAMA Intern Med. 2020;180(8):1048-1049.
Metzl JM, Maybank A, De, Maio F. Responding to the COVID-19 pandemic: the need for a structurally competent health care system. JAMA. 2020;324(3):231-232.