Abstract

BackgroundChronic conditions are common and require ongoing continuous management and preventive measures. The COVID-19 pandemic may have affected the management of chronic conditions by delaying care. We sought to understand the impact of personal characteristics (i.e., age) and healthcare factors (i.e., access to a provider) on healthcare access in a sample of Americans 50 years of age or older during COVID-19.MethodParticipants completed an online survey at the start of the COVID-19 pandemic – the Aging in the Time of COVID Survey. Questions focused on health status, health care access, COVID-19 fear, and social connectedness. Participants were recruited through social media advertisements, list serves, and snowball sampling. Data collection started in early April 2020 and concluded in late May 2020. Logistic regression models examined the results of two key access points: healthcare provider/doctor (n = 481) and medication (n = 765), with 56 and 93% of participants reporting access to a provider and medications, respectively.ResultsIndividuals with an established primary care provider were much more likely to obtain access to a healthcare provider, OR = 3.81 (95% CI: 1.69, 8.77), and to receive medication, OR = 4.48 (95% CI: 1.61, 11.48), during the time of COVID-19. In addition, access to medication was (a) higher for those who were older, OR = 1.05 (95% CI: 1.01, 1.09), had a higher income (greater than 100 k compared to less than 50 k, OR = 3.04 (95% CI: 1.11, 8.98), and (b) lower for those having caregiving responsibilities, OR = 0.41 (95% CI: 0.21, 0.78), or greater social isolation, OR = 0.93 (95% CI: 0.87, 0.98).ConclusionsAlthough most participants had access to medication, just over half had access to a healthcare provider when needed. Notably, health-seeking behaviors for individuals who do not have an established primary care providers as well as those who provide unpaid care, are socially isolated, and younger may require more proactive approaches to care monitoring, management, and maintenance.

Highlights

  • Chronic conditions are common and require ongoing continuous management and preventive measures

  • Individuals with an established primary care provider were much more likely to obtain access to a healthcare provider, OR = 3.81, and to receive medication, OR = 4.48, during the time of COVID-19

  • Many healthcare providers have voiced concern about the adverse short and long-term outcomes caused by delay or avoidance of accessing healthcare during the COVID-19 pandemic [8,9,10]

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Summary

Introduction

Chronic conditions are common and require ongoing continuous management and preventive measures. Many healthcare providers have voiced concern about the adverse short and long-term outcomes caused by delay or avoidance of accessing healthcare during the COVID-19 pandemic [8,9,10] These concerns come from an understanding that poor management of chronic conditions can lead to additional health issues, worsening of the primary problem and can increase the likelihood of an acute episode leading to an otherwise avoidable hospitalization or premature death [3, 11,12,13]. Limited or no access can have major longer-term impacts on disease incidence, exacerbations, and complications [3,4,5, 11,12,13] In this particular research, we sought to understand healthcare access (provider and medications) during COVID-19 in a sample of adults 50 years of age and older residing in the United States. Others assessed the impact of telemedicine use on outpatient care visits using claims data [14] and the benefits and barriers to virtual care for managing chronic conditions [15]

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