Abstract
Ensuring access to high-quality outpatient care is an important strategy to improve COVID-19 outcomes, reduce social inequities, and prevent potentially expensive complications of disease. This study assesses the equity of health care response to COVID-19 by examining outpatient care utilization by factors at the individual and community levels in the 12 months prior to and following COVID-19 diagnosis. Employing a retrospective, observational cohort design, we analyzed electronic health record data from a sample of 11,326 adults diagnosed with COVID-19 between March and July 2020. We used two-part models to estimate changes in use of primary and specialty care by race/ethnicity and community social vulnerability in the year before and after COVID-19 diagnosis. Our findings showed that while overall probability and counts of primary and specialty care visits increased following a positive COVID-19 diagnosis, disparities in care utilization by race/ethnicity and living in a socially vulnerable community persisted in the year that followed. These findings reiterate the need for strategic approaches to improve access to and utilization of care among those diagnosed with COVID-19, especially for individuals who are traditionally undeserved by the health system. Our findings also highlight the importance of systematic approaches for addressing social inequity in health care.
Keywords: ambulatory care; coronavirus; disparity; health care utilization.
【저자키워드】 coronavirus, Ambulatory care, disparity, health care utilization., 【초록키워드】 COVID-19, Diagnosis, outcomes, Probability, Cohort, Health, COVID-19 diagnosis, Community, Complication, health system, disease, Care, retrospective, equity, Factor, individual, positive COVID-19, approach, Prevent, highlight, IMPROVE, analyzed, changes in, reduce, diagnosed with COVID-19, Ensuring, 【제목키워드】 COVID-19, vulnerability, utilization, Outpatient, difference, Month,