Association Between a Temporary Reduction in Access to Health Care and Long-term Changes in Hypertension Control Among Veterans After a Natural Disaster

Baum, Aaron; Barnett, Michael L.; Wisnivesky, Juan P.; Schwartz, Mark D.

doi:10.1001/jamanetworkopen.2019.15111

Cited by 36 publications

(61 citation statements)

References 36 publications

(62 reference statements)

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“…This would be consistent with evidence from natural disasters resulting in decreased access to care associated with greater morbidity and mortality not directly related to the disaster itself. 6 An important limitation is that results may not generalize to other populations (eg, traditional Medicare or Medicaid). Telemedicine use during the early COVID-19 pandemic only partially offset a drop in total outpatient care.…”

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confidence: 99%

Trends in Outpatient Care Delivery and Telemedicine During the COVID-19 Pandemic in the US

et al. 2021

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Trends in Outpatient Care Delivery and Telemedicine During the COVID-19 Pandemic in the US

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“…Table 2 provides a summary of included studies. Of 58 included studies, 24 studies (13, investigated exposure to disasters during pregnancy or childhood while the remaining 34 studies (12,) investigated exposure to disaster during adulthood. Almost all studies (n=49) assessed cardiometabolic outcomes during adulthood, only two studies assessed outcomes during pregnancy (25,26) and seven studies assessed outcomes during childhood and adolescence (13,(19)(20)(21)(22)(23)(24).…”

Section: Resultsmentioning

confidence: 99%

“…The length of studies, including prospective follow-up and retrospective assessment, ranged from 1 month to 95 years. Most studies (n=36) focused on disasters that occurred in North America (12,(19)(20)(21)(22)(23)(24)(25)(26)36,37,40,(43)(44)(45)(46)(47)49,50,52,53,(55)(56)(57)(58)(61)(62)(63)(65)(66)(67)(68)(69)(70)73,74), followed by Europe (n=13) (27)(28)(29)(30)(31)(32)(33)39,41,51,60,71,72). The remaining disasters occurred in Asia (n=7)…”

Section: Resultsmentioning

confidence: 99%

Impact of disasters, including pandemics, on cardiometabolic outcomes across the life-course: A systematic review

Rubeis

Lee

Anwer

et al. 2020

Preprint

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ObjectivesDisasters, such as the current COVID-19 pandemic, disrupt daily life, increase uncertainty and stress, and may increase long-term risk of adverse cardiometabolic outcomes, including heart disease, obesity and diabetes. The objective was to conduct a systematic review to determine the impact of disasters, including pandemics, on cardiometabolic outcomes across the life-course.DesignA systematic search was conducted in May 2020 using two electronic databases, EMBASE and Medline. All studies were screened in duplicate at title and abstract, and full-text level. Studies were eligible for inclusion if they assessed an association with population-level or community disaster and cardiometabolic outcomes. There were no restrictions on year of publication, country or population. Non-English and earthquake-related studies were excluded. Data were extracted on study characteristics, exposure (e.g., type of disaster, name of specific event, region, year), cardiometabolic outcomes, and measures of effect. Study quality was evaluated using the Joanna Briggs Institute critical appraisal tools.ResultsA total of 58 studies were included, with 24 studies reporting the effects of exposure to disaster during pregnancy/childhood and 34 studies reporting the effects of exposure during adulthood. Studies included exposure to natural (60%) and human-made (40%) disasters, with only 3 (5%) of these studies evaluating previous pandemics. Most studies were conducted in North America (62%). Most studies reported increased cardiometabolic risk, including increased cardiovascular disease incidence or mortality, diabetes, and obesity. Few studies investigated potential mechanisms or identified high risk subgroups.ConclusionsUnderstanding the long-term consequences of disasters on cardiometabolic outcomes across the life-course may inform public health strategies for the current COVID-19 pandemic. This review found strong evidence of an increased association between disaster exposure and cardiometabolic outcomes across the life-course, although more research is needed to better understand the mechanisms and preventative efforts.PROSPERO registrationCRD – 42020186074Strengths and limitations of this studyThis systematic review is one of the first to review the literature on disasters, including pandemics, and subsequent cardiometabolic outcomes throughout the life-course.A comprehensive search strategy was developed in consultation with Health Science Librarians at McMaster University, which resulted in 58 studies that were eligible for inclusion into the review.Due to the heterogeneity of the included studies, a meta-analysis was not conducted.This review contributes a synthesis of the literature on the impact of disasters and cardiometabolic outcomes, that can help to inform public health strategies for the current COVID-19 pandemic.

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“…This concern is motivated by research documenting noteworthy disruptions in care and an increased reliance on emergency departments associated with changes in insurance plans. [13][14][15][16] Narrow network plans have also been shown to have lower annual limits on patient out-of-pocket spending and prohibitions on annual and lifetime insurer spending maximums-apply to nearly all private health insurance plans but only for care received by in-network clinicians and hospitals. Given these considerations, it is important to know whether patients will be able to affordably maintain preferred clinical relationships if and when they change insurance plans.…”

Section: Discussionmentioning

confidence: 99%

Breadth and Exclusivity of Hospital and Physician Networks in US Insurance Markets

et al. 2020

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Key Points Question How does the breadth of health care networks and the degree to which they overlap vary within and across specialties and insurance markets? Findings In this cross-sectional study of 1192 health care networks, large-group employer networks were broader than small-group employer, marketplace, Medicare Advantage, and Medicaid managed care networks. In many states, narrower networks had as much, if not more, overlap across different insurers’ networks than the broadest networks; areas with less concentrated insurance, physician, and hospital markets had narrower and more exclusive networks. Meaning These findings suggest that the structure of plan networks may be a factor in determining care affordability and continuity in the United States, particularly given how frequently individuals change insurance plans.

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Association Between a Temporary Reduction in Access to Health Care and Long-term Changes in Hypertension Control Among Veterans After a Natural Disaster

Cited by 36 publications

References 36 publications

Trends in Outpatient Care Delivery and Telemedicine During the COVID-19 Pandemic in the US

Trends in Outpatient Care Delivery and Telemedicine During the COVID-19 Pandemic in the US

Impact of disasters, including pandemics, on cardiometabolic outcomes across the life-course: A systematic review

Breadth and Exclusivity of Hospital and Physician Networks in US Insurance Markets

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