Which Patient Populations Saw The Most COVID Care Access Delays? | #insurance | #seniors | #elderly
– Older White people in fair or poor health were more likely to see involuntary care access delays at the hands of the COVID-19 pandemic than their peers, a finding researchers said could help shape patient re-engagement efforts now that a vaccine is available.
The data, published in the latest issue of Health Affairs and obtained via email, relied heavily on the term “involuntary,” indicating that those who were most likely to be accessing healthcare before the pandemic were the most likely to have had their care canceled or delayed because of it, too. Those who were never likely to access healthcare didn’t see much disruption, because there wasn’t much access to disrupt, the researchers reasoned.
That finding, too, indicates a path forward for patient re-engagement, especially in light of the racial health disparities so starkly observed during the COVID-19 outbreak. Black patients and patients without insurance coverage didn’t report as many involuntary care access delays because they needed stronger access to care overall, the team suggested.
Missed and delayed healthcare access, and its impact on chronic disease management and prevention, have been serious questions for the healthcare industry over the past year. Between shutdowns in elective or non-essential healthcare access and patients’ own fears about in-person healthcare access even after shutdowns abated, patient access to care slowed considerably.
Using data from the Current Population Survey’s COVID-19 supplement, the researchers were able to boil down the populations most affected.
By and large, White, older patients in fair or poor health and with access to health insurance were most likely to have their care involuntarily delayed or canceled during the pandemic. Additionally, having a work-limiting injury increased the odds of involuntary care access delays.
The researchers defined “involuntary” as a care access delay that had been initiated by the healthcare provider and not the patient.
“Some of these findings likely reflect the fact that those who tend to use more care (for example, older people, women, insured people, and people in poor health or with a disability) are also more likely to have had that care disrupted during the pandemic,” the researchers explained. “This would be a pattern consistent with a constant level of disruption of care across all users of the system.”
This logic tracks when looking at racial minorities, who the survey indicated were less likely to report involuntarily delayed or canceled care access during the pandemic. Because traditionally marginalized races and those without insurance coverage are overall less likely to access care regardless of a pandemic, COVID-19 had a smaller impact.
The researchers were more stumped by findings that individuals with higher educational attainment were more likely to see involuntary delayed care access. The researchers noted the link between educational attainment and lifelong wellness habits, saying they expected to see fewer reported disruptions among more-educated respondents.
However, the team also noted the link between education and income, explaining that low-income patients are usually more likely to access acute care in emergency or urgent settings. As emergency care was never shut down during the pandemic, those with lower educational attainment and lower income may not have seen as many disruptions, the team posited.
The researchers also flagged the finding that those ages 65 to 75 were more likely to report delayed care than those over age 75. Again, it could be safe to assume those over age 75 have more healthcare needs, opening the door for them to experience more care disruptions.
“One potential explanation is that less urgent care for the older subset of elderly adults, who faced greater mortality risk associated with COVID-19 infection relative to their slightly younger peers, was more likely to be delayed or cancelled proactively by providers,” the research team wrote.
The study authors said these findings could inform efforts to mitigate care access delays during future public health crises.
Additionally, findings may inform population-level patient re-engagement interventions as the nation begins to see higher vaccination rates and a potential transition to regular order. Understanding which patients may have experienced a delay in healthcare could help organizations target their patient outreach efforts to close potential care gaps.