An examination of health care utilization during the COVID-19 pandemic among women with early-stage hormone receptor-positive breast cancer.
An examination of health care utilization during the COVID-19 pandemic among women with early-stage hormone receptor-positive breast cancer.
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DOI：
10.1186/s12913-022-08705-9
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发表时间：
2022-11-23
影响因子：
2.8
通讯作者：
Graetz, Ilana
中科院分区：
文献类型：
--
作者：
Paladino, Andrew J.;Pebley, Kinsey;Kocak, Mehmet;Krukowski, Rebecca A.;Waters, Teresa M.;Vidal, Gregory;Schwartzberg, Lee S.;Curry, Andrea N.;Graetz, Ilana
接受乳腺癌治疗的妇女需要经常到诊所就诊以维持治疗。随着COVID-19导致医疗服务中断，重要的是要了解这一人群获得医疗服务的方式发生了怎样的变化。这项研究比较了大流行之前和期间在美国中南部癌症中心接受治疗的妇女自我报告的卫生保健利用率和与卫生保健获得相关的因素变化。参与者（N = 306）的纵向研究，以提高辅助内分泌治疗（AET）的依从性，完成了干预前的基线调查，他们的医疗保健利用AET开始之前。在疫情开始评估财务损失及护理相关因素后，增加了有关COVID-19影响的问题。参与者根据调查完成日期分为三个时间段：（1）COVID前（2018年12月至2020年3月），（2）COVID早期（2020年4月至2020年12月），以及COVID后期（2021年1月至2021年6月）。负二项回归分析用于在控制患者特征的情况下比较大流行不同阶段的卫生保健利用情况。调整后的分析表明，办公室就诊次数从新冠疫情爆发前的17.7次调整后平均就诊次数下降至新冠疫情早期的12.1次（p = 0.01）和新冠疫情后期的9.9次（p < 0.01）。在疫苗上市后，住院率从COVID早期的调整后平均0.45例下降到COVID后期的0.21例（p = 0.05）。在新冠疫情期间的参与者中，报告健康保险覆盖范围变化/差距的参与者比例从新冠疫情早期的9.5%增加到新冠疫情后期的14.8%（p = 0.05）。于两个COVID期间，因疫情而报告财务亏损的比例相若（COVID早期为34. 3%，COVID后期为37. 7%，p = 0. 72）。报告延迟护理或重新配药的参与者比例从COVID早期的15.2%下降到COVID后期的4.9%（p = 0.04）。COVID-19导致乳腺癌妇女的常规医疗保健中断。患者报告说，在大流行开始时，就诊次数减少，即使在疫苗问世后，这种情况仍在继续减少。随着大流行的发展，报告延迟亲自护理的患者越来越少。在线版本包含补充材料，可通过10.1186/s12913-022-08705-9获得。
Women undergoing treatment for breast cancer require frequent clinic visits for maintenance of therapy. With COVID-19 causing health care disruptions, it is important to learn about how this population’s access to health care has changed. This study compares self-reported health care utilization and changes in factors related to health care access among women treated at a cancer center in the mid-South US before and during the pandemic. Participants (N = 306) part of a longitudinal study to improve adjuvant endocrine therapy (AET) adherence completed pre-intervention baseline surveys about their health care utilization prior to AET initiation. Questions about the impact of COVID-19 were added after the pandemic started assessing financial loss and factors related to care. Participants were categorized into three time periods based on the survey completion date: (1) pre-COVID (December 2018 to March 2020), (2) early COVID (April 2020 – December 2020), and later COVID (January 2021 to June 2021). Negative binomial regression analyses used to compare health care utilization at different phases of the pandemic controlling for patient characteristics. Adjusted analyses indicated office visits declined from pre-COVID, with an adjusted average of 17.7 visits, to 12.1 visits during the early COVID period (p = 0.01) and 9.9 visits during the later COVID period (p < 0.01). Hospitalizations declined from an adjusted average 0.45 admissions during early COVID to 0.21 during later COVID, after vaccines became available (p = 0.05). Among COVID period participants, the proportion reporting changes/gaps in health insurance coverage increased from 9.5% participants during early-COVID to 14.8% in the later-COVID period (p = 0.05). The proportion reporting financial loss due to the pandemic was similar during both COVID periods (34.3% early- and 37.7% later-COVID, p = 0.72). The proportion of participants reporting delaying care or refilling prescriptions decreased from 15.2% in early-COVID to 4.9% in the later-COVID period (p = 0.04). COVID-19 caused disruptions to routine health care for women with breast cancer. Patients reported having fewer office visits at the start of the pandemic that continued to decrease even after vaccines were available. Fewer patients reported delaying in-person care as the pandemic progressed. The online version contains supplementary material available at 10.1186/s12913-022-08705-9.
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影响因子：
4
作者：
Hawrot K;Shulman LN;Bleiweiss IJ;Wilkie EJ;Frosch ZAK;Jankowitz RC;Laughlin AI
通讯作者：
Laughlin AI
影响因子：
3.7
作者：
Wilke LG;Nguyen TT;Yang Q;Hanlon BM;Wagner KA;Strickland P;Brown E;Dietz JR;Boughey JC
通讯作者：
Boughey JC
影响因子：
3.8
作者：
Versmessen H;Vinh-Hung V;Van Parijs H;Miedema G;Voordeckers M;Adriaenssens N;Storme G;De Ridder M
通讯作者：
De Ridder M
影响因子：
6.1
作者：
VUONG, QH
通讯作者：
VUONG, QH
影响因子：
3.1
作者：
Hilarius, Doranne L.;Kloeg, Paul H.;Aaronson, Neil K.
通讯作者：
Aaronson, Neil K.