J Health Care Poor Underserved. 2021;32(1):137-144. doi: 10.1353/hpu.2021.0013.
The COVID-19 pandemic has brought about a precipitous transformation in health care delivery in the nation's safety-net, primary care system of federally qualified health centers (FQHCs). This study uses electronic health record data to quantify the extent of changes to visit volume in 36 FQHCs across 19 states as well as changes in quality metrics. We found a steep decline in in-person visits in March 2020 accompanied by a sharp increase in telehealth visits; however, combined volume remained 23% below pre-pandemic levels. The implications for public health are significant, as preventive and chronic care deferral could lead to exacerbations of health disparities. Our examination of the impact on quality measures suggests that gaps in care are already emerging. Services that cannot be readily performed virtually are most affected. As FQHC visit numbers recover, concerted efforts are needed to encourage access and re-engage at-risk groups that fell out of care.
COVID-19 大流行使美国的医疗保障体系，即联邦合格健康中心（FQHC）的初级保健系统中的医疗服务提供方式发生了急剧转变。本研究使用电子健康记录数据来量化 19 个州的 36 个 FQHC 中就诊量的变化程度以及质量指标的变化情况。我们发现，2020 年 3 月，门诊量急剧下降，与此同时，远程医疗就诊量急剧上升；然而，总就诊量仍比大流行前低 23%。这对公共卫生具有重大意义，因为预防和慢性护理的延迟可能会导致健康差距加剧。我们对质量措施的影响进行了研究，结果表明，护理差距已经开始显现。那些无法通过远程医疗提供的服务受到的影响最大。随着 FQHC 就诊人数的恢复，需要共同努力，鼓励那些已经脱离护理的高危人群重新获得医疗服务并重新参与其中。
