Satisfaction With Access To Health Services In West Virginia Despite Covid-19

Abstract

IntroductionCenters for Disease Control and Prevention reported COVID-19 significantly impacts health services for chronic health conditions including patients with cardiovascular disease. This study was conducted as an immediate follow-up on study participants who enrolled in the heart failure (HF) clinical trial (1R15NR018547-01) testing home palliative care coaching for patients with HF and their family caregivers in rural Appalachia.HypothesisCOVID-19 impacts HF patients and their caregivers’ (1) overall quality of life (QoL) and health satisfaction, and (2) access to health care and community services.MethodsThis is a descriptive study conducted between August 2020 to March 2021, using a structured telephone survey with open-ended questions. The questions include demographic queries, frequency of health services use, overall quality of life and health during social distancing and the COVID-19 pandemic.ResultsOf 13 participants enrolled in the study, the majority were white (85%) and married (61.5%). HF patients were predominantly male (83%), and caregivers were female (85.7%). The mean age of HF patients was 63 (SD=16.8) and family caregivers was 60.7 (SD=12.9) years. Twenty-three percent of participant couldn't financially make ends meet, while another 23.1% reported having barely enough. On a scale of 1-5, the patients were satisfied with their overall QoL (Mean = 3.83 (SD=1.17), but half of caregivers reported average and poor QoL (Mean = 3.17 (SD=0.98). However, 70% of caregivers were satisfied with their health (Mean=3.71 (SD=1.25), while half of the patients reported neutral satisfaction or dissatisfaction with their health (Mean=3.17 (SD=0.98). All patients were able to attend in-person appointments. Notably, 50% of patients reported phone calls and 33% used telehealth for their appointments. A majority of patients reported calling (83%) and receiving calls (67%) from their doctors or nurses. The reasons for calls were related to health issues, lab reports, medications, and dose adjustments. Three patients reported emergency room (ER) visits and two had HF-related hospital admissions. One caregiver had an ER visit. Overall, a few participants (15%) used community services, including hospice and visiting nurses and found them useful. About 70% of participants reported sufficient healthcare, while one-third (30%) did not and reported difficulty in getting medications and rescheduling appointments after cancellation.ConclusionsCOVID-19 has an impact on QoL and health of patients with HF and their family caregivers. These families need care coordination from their healthcare providers to maintain HF home care. Many families need help with their prescriptions, monitoring and managing symptoms, scheduling appointments, and preventing unwarranted hospitalizations.