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Related Concept Videos

Issues And Trends In Healthcare Delivery System01:29

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The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
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Socioeconomically Disadvantaged Groups May Have Underused The Emergency Department For Nonavoidable Visits, 2018-22.

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The COVID-19 pandemic reduced potentially avoidable emergency department (ED) visits for all, but disadvantaged groups may now be underusing the ED for serious illnesses, indicating new healthcare access disparities.

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Area of Science:

  • Health Services Research
  • Health Economics
  • Public Health

Background:

  • Emergency department (ED) use increased faster among socioeconomically disadvantaged populations before the COVID-19 pandemic.
  • Barriers to office-based care contributed to increased ED utilization among disadvantaged groups.
  • The pandemic's long-term impact on socioeconomic disparities in ED use remains unclear.

Purpose of the Study:

  • To investigate the durable effects of the COVID-19 pandemic on socioeconomic disparities in emergency department (ED) use.
  • To compare ED visit rates during the pandemic (March 2020-August 2022) with pre-pandemic rates (2018-19).

Main Methods:

  • Retrospective cohort study utilizing US multipayer claims data.
  • Difference-in-differences analysis comparing ED visit rates between pandemic and pre-pandemic periods.
  • Stratification by insurance type (commercial, Medicare, Medicaid, dual-eligible) to assess socioeconomic disparities.

Main Results:

  • Potentially avoidable ED visits decreased across all insured groups during the pandemic.
  • Potentially nonavoidable ED visits initially declined but largely rebounded to pre-pandemic levels for commercially insured and Medicare patients.
  • Potentially nonavoidable ED visits only returned to approximately 75% of expected rates for Medicaid and dual-eligible patients.
  • A disparity emerged with socioeconomically disadvantaged groups potentially underusing the ED for higher-acuity conditions.

Conclusions:

  • The pandemic reduced potentially avoidable ED use but may have exacerbated disparities in accessing necessary care.
  • Socioeconomically disadvantaged populations, particularly those with Medicaid or dual eligibility, showed underuse of ED services for potentially nonavoidable visits.
  • Findings suggest a need to address underlying barriers to care access for vulnerable populations to prevent underuse of emergency services for acute conditions.