Disruption of Medical Care among Individuals in the Southeastern United States during the COVID-19 Pandemic

Abstract

Background: Widespread disruptions of medical care to mitigate COVID-19 spread and reduce burden on healthcare systems may have deleterious public health consequences.Design and Methods: To examine factors contributing to healthcare interruptions during the pandemic, we conducted a COVID-19 impact survey between 10/7-12/14/2020 among participants of the Southern Community Cohort Study, which primarily enrolled low-income individuals in 12 southeastern states from 2002-2009. COVID survey data were combined with baseline and follow-up data.Results: Among 4,463 respondents, 40% reported having missed/delayed a health appointment during the pandemic; the common reason was provider-initiated cancellation or delay (63%). In a multivariable model, female sex was the strongest independent predictor of interrupted care, with odds ratio (OR) 1.63 (95% confidence interval [CI] 1.40-1.89). Those with higher education (OR 1.27; 95% CI 1.05-1.54 for college graduate vs ≤high school) and household income (OR 1.47; 95% CI 1.16-1.86 for >$50,000 vs <$15,000) were at significantly increased odds of missing healthcare. Having greater perceived risk for acquiring (OR 1.42; 95% CI 1.17-1.72) or dying from COVID-19 (OR 1.25; 95% CI 1.04-1.51) also significantly increased odds of missed/delayed healthcare. Age was inversely associated with missed healthcare among men (OR for 5-year increase in age 0.88; 95% CI 0.80-0.96) but not women (OR 0.97; 95% CI 0.91-1.04; p-interaction=0.04). Neither race/ethnicity nor comorbidities were associated with interrupted healthcare.Conclusions: Disruptions to healthcare disproportionately affected women and were primarily driven by health system-initiated deferrals and individual perceptions of COVID-19 risk, rather than medical co-morbidities or other traditional barriers to healthcare access.

Life Satisfaction and Perceived Stress versus Health Promoting Behavior among Medical Students during the COVID-19 Pandemic

“…Preventive behaviors during this particular period could be associated with increased stress for various reasons. During the pandemic, access to health care was significantly limited; therefore, it became difficult to conduct any preventive examinations during this period [ 46 , 47 , 48 , 49 ]. On the other hand, constant reminding and emphasizing the need to maintain social distance, wearing masks, and frequent hand washing could generate stress by the very fact of the enormous importance that these behaviors acquired during this time [ 50 , 51 ].…”

Effects of COVID-19 pandemic on the management of pulmonary hypertension

“…A significant decrease in healthcare utilization occurred in March of 2020, when the World Health Organization (WHO) first announced pandemic status, with dramatic drops in office visits in the following weeks [ 1 , 2 ]. Estimates of missed or delayed care ranged from 20% to over 40% of adults in the United States [ 3 , 4 ]. In one study, basic laboratory testing during the early pandemic decreased by 81–90% and new medication therapy prescriptions for even common drugs decreased by 52–60% [ 5 ].…”

“…In one study, basic laboratory testing during the early pandemic decreased by 81–90% and new medication therapy prescriptions for even common drugs decreased by 52–60% [ 5 ]. There is an increased likelihood of healthcare delays among women and patients who had greater perceived risk from COVID-19 infection [ 3 ].…”

Reduced Access to Preventive Care Due to the COVID-19 Pandemic, by Chronic Disease Status and Race and Hispanic Origin, United States, 2020-2021

“…Among the 4463 respondents, 40% reported missing or delaying a health appointment during the pandemic, with the most common reason being provider-initiated cancellation or delay. 4 …”

“…Among the 4463 respondents, 40% reported missing or delaying a health appointment during the pandemic, with the most common reason being provider-initiated cancellation or delay. 4 While many studies have indicated worse access to care during the pandemic compared with previous years, the impact of the pandemic on access to care has varied among demographic groups. 5,6 In an online survey of a representative sample of US adults conducted in June 2020, approximately 40% of adults avoided medical care during the pandemic because of concerns about COVID-19, including 12.0% who avoided urgent or emergency care and 31.5% who avoided routine care.…”