Disruptions to in-person medical visits across the United States during the COVID-19 pandemic: Evolving disparities by medical specialty and socio-economic status

This study aimed to investigate how people's health-seeking behaviors evolve in the COVID-19 pandemic by community and medical service category. This is a longitudinal study using mobility data from 19 million mobile devices of visits to all types of health facility locations for all US states. The authors examine the variations in weekly in-person medical visits across county, neighborhood, and specialty levels. Different regression models are used for each level to investigate factors that influence the disparities in medical visits. County-level analysis explores associations between county medical visit patterns, political orientation, and COVID-19 infection rate. Neighborhood-level analysis focuses on neighborhood socio-economic compositions as potential determinants of medical visit levels. Specialty-level analysis compares the evolution of visit disruptions in different specialties. A more left-leaning political orientation and a higher local infection rate were associated with larger decreases in in-person medical visits, and these associations became stronger, moving from the initial period of stay-at-home orders into the post-lockdown period. Initial reactions were strongest for seniors and those of high socio-economic status, but this reversed in post-lockdown period where socio-economically disadvantaged communities stabilized at a lower level of medical visits. Neighborhoods with more female and young people exhibited larger decreases in in-person medical visits throughout the initial and post-lockdown periods. The evolution of disruptions diverges across medical specialties, from only short-term disruption in specialties such as dentistry to increasing disruption, as in cardiology. Given distinct patterns in visit between communities, medical service categories, and between different periods in the pandemic, policy makers, and providers should concentrate on monitoring patients in disrupted specialties who overlap with the at-risk contexts and socio-economic factors in future health emergencies.

• Record URL:
  • https://doi.org/10.1016/j.puhe.2023.06.011
• Record URL:
  • http://www.sciencedirect.com/science/article/pii/S0033350623001993
• Availability:
  • Find a library where document is available. Order URL: http://worldcat.org/issn/00333506
• Supplemental Notes:
  • © 2023 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved. Abstract reprinted with permission of Elsevier.
• Authors:
  • Liu, Weixin
  • 0000-0002-2726-3826
  • Li, J
  • Dalton, C M
• Publication Date: 2023-8

Language

• English

Media Info

• Media Type: Web
• Features: References;
• Pagination: pp 116-123
• Serial:
  • Public Health
  • Volume: 221
  • Issue Number: 0
  • Publisher: Elsevier
  • ISSN: 0033-3506
  • Serial URL: http://www.sciencedirect.com/science/journal/00333506

Subject/Index Terms

• TRT Terms: COVID-19; Health care services; Social factors; Travel behavior; Travel restrictions
• Geographic Terms: United States
• Subject Areas: Highways; Safety and Human Factors; Society;

Filing Info

• Accession Number: 01889166
• Record Type: Publication
• Files: TRIS
• Created Date: Jul 27 2023 4:55PM