CORE examines COVID-19’s disparate impacts on health care utilization

Two new papers from the Center for Outcomes Research and Education (CORE) examine disparities in access to care for COVID-19 patients in both virtual and in-person settings.

Ensuring consistent access to high-quality health care is essential to responding to the COVID-19 pandemic. Yet past research has shown that racial and ethnic minorities and patients living in communities with lower incomes face barriers to accessing care. That’s a significant challenge to an effective COVID-19 response, as a mounting body of evidence points to an increased use of health care services following COVID-19 diagnosis as many as nine months or more after disease onset.

To advance understanding and help inform strategies that reduce these disparities, researchers at CORE examined the impacts of COVID-19 on the use of health care across race/ethnicity, as well as the social vulnerability index, which uses U.S. Census data to determine the relative social vulnerability of every census tract. The study, funded through a grant by the Housman Foundation, included 11,326 adult patients diagnosed with COVID-19 between March and July 2020. Key findings were published in early 2022 in two peer reviewed journal articles.

• The first article, published in the International Journal of Environmental Research, describes differences in outpatient healthcare utilization by race/ethnicity and community social vulnerability 12 months after COVID-19 infection. Findings showed that while a COVID-19 diagnosis is often linked to a near-term increase in primary care and specialty visits, disparities in care utilization by race/ethnicity and social vulnerability persisted in the year that followed.
• In the journal BMC Health Services Research, CORE describes differences in access to virtual and in-person primary care among adults diagnosed with COVID-19. The researchers found that patients who are Hispanic/Latino, Native Hawaiian/Pacific Islander and those living in socially vulnerable areas have not equitably benefited from the overall expansion in virtual care brought about by the Pandemic, and that those disparities have not been offset by improved in-person access.

These findings illustrate the need for strategic and evidence-based approaches to improve access to and utilization of care among those diagnosed with COVID-19, especially for individuals who are traditionally underserved by the health care system, in order to address the long-term impact of the pandemic. As health care systems look to expand virtual care, specific efforts are needed to ensure it is done in an equitable and culturally responsive manner.

To learn more, read the full articles at the links below. You can also find a list of other reports and peer-reviewed publications at CORE’s website

• Roth S, Govier DJ, Marsi K, and Cohen-Cline H. “Differences in Outpatient Health Care Utilization 12 Months after COVID-19 Infection by Race/Ethnicity and Community Social Vulnerability.” Int. J. Environ. Res. Public Health. 2022
• Govier DJ, Cohen-Cline H, Roth S. “Differences in Access to Virtual and In-Person Primary Care by Race/Ethnicity and Community Social Vulnerability Among Adults Diagnoses with COVID-19 in a Large Multi-State Health System.” BMC Health Service Research. 2022