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Principal Investigator: Cameron Maxwell Kaplan
Organization: UNIVERSITY OF SOUTHERN CALIFORNIA
Fiscal Year: 2024
Award: $468,962
Funding agency: National Institute on Minority Health and Health Disparities
As a result of mitigation policy and behavioral changes, the COVID-19 pandemic significantly reduced access to primary care, which is likely to have lasting effects on chronic disease management and health outcomes, particularly for under-resourced populations with existing chronic conditions. Newly available longitudinal individual-level data allows us to rigorously examine these effects for the first time.
Although there is a large and growing literature quantifying racial/ethnic disparities in outcomes related to COVID-19, relatively less is known about how the pandemic has affected access to primary and preventive care as well as associated health outcomes among under-resourced populations. Understanding how the pandemic affected the utilization of preventive health care and management of chronic conditions, such as diabetes mellitus (DM) and hypertension (HTN), as well as the downstream outcomes, is critical to addressing resultant health disparities and mitigating the impact of future disruptions to the healthcare system and advancing interventions and policies to reduce health disparities
We will leverage this newly available and timely data to examine changes in receipt of healthcare during the pandemic. Our data will include commercial health insurance claims in addition to a unique dataset containing billing data for a large, urban safety-net county health system serving a low-income patient population with a large population of racial/ethnic minorities. Within those populations, we will include a special focus examining individuals with DM or HTN. Using a mixed-methods design, we will examine changes in health care utilization and the predictors of disruptions over time. To more comprehensively understand contextual influences related to disruptions in care, we will obtain complementary qualitative data through interviews with patients, providers and clinic staff, and health systems leaders from the second largest municipal health system in the United States that will explore the drivers of underutilization of primary and preventive care during and after the pandemic. Our specific aims are to: (1) quantify the impact of the pandemic on racial/ethnic disparities in receipt of appropriate primary care, chronic disease management, and downstream health outcomes; (2) compare the differential effect of pandemic mitigation efforts between a commercially insured population and a safety net population; and (3) contextualize the secondary health effects of the pandemic using qualitative interviews with health systems stakeholders.
Using established and novel data sets, supplemented by qualitative interviews we will be able to shed light on the changes in patterns of care management both during and after the pandemic for under-resourced patients. Such information is crucial to determining how we should direct health care resources during national crises. However, these results are equally important in a post-pandemic landscape, in which the way patients seek care and health systems offer care is permanently altered.
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mortality><COVID19 related death><COVID19 related fatality><COVID19 related mortality><CV-19><Caring><Chronic><Chronic Disease><Chronic Illness><Clinic><Contracting Opportunities><Contracts><Coronavirus Infectious Disease 2019><County><Data><Data Analyses><Data Analysis><Data Set><Decrease health disparities><Diabetes Mellitus><Disease Management><Disorder Management><Disparities><Disparity><Disparity population><Economic Income><Economical Income><Equity><Ethnic Origin><Ethnicity><Future><Guidelines><Health><Health Care Systems><Health Care Utilization><Health Insurance><Health Resources><Health disparity mitigation><Health disparity reduction><Health system><Healthcare><Healthcare Systems><Hospital Admission><Hospitalization><Hypertension><Income><Individual><Intervention><Intervention Strategies><Interview><Literature><Low Income Population><Low income><Low income group><Lower health disparities><Managed Care><Measures><Methods><Mitigate health disparities><Morbidity><Morbidity - disease rate><Municipalities><Outcome><Outpatient Care><Patients><Patterns of Care><Persons><Pharmaceutical Agent><Pharmaceuticals><Pharmacologic Substance><Pharmacological Substance><Physical distancing><Policies><Policy Maker><Population><Preventative care><Preventative health care><Preventative healthcare><Preventive care><Preventive health care><Preventive healthcare><Primary Care><Primary Health Care><Primary Healthcare><Provider><Race><Races><Recommendation><Reduce health disparities><Renal function><Research Resources><Resources><Risk><SARS-CoV-2 associated death><SARS-CoV-2 associated fatality><SARS-CoV-2 associated mortality><SARS-CoV-2 death><SARS-CoV-2 epidemic><SARS-CoV-2 fatality><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 induced death><SARS-CoV-2 induced fatality><SARS-CoV-2 induced mortality><SARS-CoV-2 mortality><SARS-CoV-2 pandemic><SARS-CoV-2 related death><SARS-CoV-2 related fatality><SARS-CoV-2 related mortality><SARS-coronavirus-2 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groups><insurance claims><interventional strategy><kidney function><life-threatening COVID><life-threatening COVID-19><life-threatening SARS-CoV-2><life-threatening coronavirus disease><life-threatening coronavirus disease 2019><life-threatening severe acute respiratory syndrome coronavirus 2><low income individual><low income people><medical vulnerability><minority patient><mortality due to COVID-19><mortality due to COVID19><mortality due to SARS-CoV-2><mortality due to coronavirus disease 2019><mortality due to severe acute respiratory syndrome coronavirus 2><novel><outpatient treatment><pandemic><pandemic containment><pandemic control><pandemic disease><pandemic effect><pandemic impact><pandemic mitigation><pandemic outcome><pandemic repercussions><pandemic response><patient population><patients from minority><patients of minority><pharmaceutical><population inequality><population inequity><post-pandemic><primary care services><race based disparity><race based inequality><race 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