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Differences in Outpatient Health Care Utilization 12 Months after COVID-19 Infection by Race/Ethnicity and Community Social Vulnerability

Author

Listed:
  • Sarah E. Roth

    (Center for Outcomes Research and Education (CORE), Providence, 5211 NE Glisan Street, Portland, OR 97213, USA)

  • Diana J. Govier

    (Center for Outcomes Research and Education (CORE), Providence, 5211 NE Glisan Street, Portland, OR 97213, USA)

  • Katherine Marsi

    (Center for Outcomes Research and Education (CORE), Providence, 5211 NE Glisan Street, Portland, OR 97213, USA)

  • Hannah Cohen-Cline

    (Center for Outcomes Research and Education (CORE), Providence, 5211 NE Glisan Street, Portland, OR 97213, USA)

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.

Suggested Citation

  • Sarah E. Roth & Diana J. Govier & Katherine Marsi & Hannah Cohen-Cline, 2022. "Differences in Outpatient Health Care Utilization 12 Months after COVID-19 Infection by Race/Ethnicity and Community Social Vulnerability," IJERPH, MDPI, vol. 19(6), pages 1-15, March.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:6:p:3481-:d:771740
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    References listed on IDEAS

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    1. Jessica D. Bellinger & Rahnuma M. Hassan & Patrick A. Rivers & Qiang Cheng & Edith Williams & Saundra H. Glover, 2010. "Specialty Care Use in US Patients with Chronic Diseases," IJERPH, MDPI, vol. 7(3), pages 1-16, March.
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    4. Samuel D. Towne Jr., 2017. "Socioeconomic, Geospatial, and Geopolitical Disparities in Access to Health Care in the US 2011–2015," IJERPH, MDPI, vol. 14(6), pages 1-15, May.
    5. Federico Belotti & Partha Deb & Willard G. Manning & Edward C. Norton, 2015. "twopm: Two-part models," Stata Journal, StataCorp LP, vol. 15(1), pages 3-20, March.
    6. Yin Paradies & Jehonathan Ben & Nida Denson & Amanuel Elias & Naomi Priest & Alex Pieterse & Arpana Gupta & Margaret Kelaher & Gilbert Gee, 2015. "Racism as a Determinant of Health: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 10(9), pages 1-48, September.
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    1. Jacqueline A. Krysa & Sidney Horlick & Kiran Pohar Manhas & Katharina Kovacs Burns & Mikayla Buell & Maria J. Santana & Kristine Russell & Elizabeth Papathanassoglou & Chester Ho, 2023. "Accessing Care Services for Long COVID Sufferers in Alberta, Canada: A Random, Cross-Sectional Survey Study," IJERPH, MDPI, vol. 20(15), pages 1-14, July.

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