Yousman Laurie C, Khunte Akshay, Hsiang Walter, Jain Siddharth, Forman Howard, Wiznia Daniel
Yale University School of Medicine, New Haven, USA.
Yale University School of Medicine, Department of Radiology, New Haven, USA.
BMC Health Serv Res. 2021 Apr 8;21(1):318. doi: 10.1186/s12913-021-06338-y.
In a response to the pandemic, urgent care centers (UCCs) have gained a critical role as a common location for COVID-19 testing. We sought to characterize the changes in testing accessibility at UCCs between March and August 2020 on the basis of testing availability (including rapid antigen testing), wait time for test results, cost of visits, and cost of tests.
Data were collected using a secret shopper methodology. Researchers contacted 250 UCCs in 10 states. Investigators used a standardized script to survey centers on their COVID-19 testing availability and policies. UCCs were initially contacted in March and re-called in August. T-tests and chi-square tests were conducted to identify differences between March and August data and differences by center classification.
Our results indicate that both polymerase chain reaction (PCR) tests to detect COVID-19 genetic material and rapid antigen COVID-19 tests have increased in availability. However, wait times for PCR test results have significantly increased to an average of 5.79 days. Additionally, a high proportion of UCCs continue to charge for tests and visits and no significant decrease was found in the proportion of UCCs that charge for COVID-19 testing from March to August. Further, no state reported a majority of UCCs with rapid testing available, indicating an overall lack of rapid testing.
From March to August, COVID-19 testing availability gradually improved. However, many barriers lie in access to COVID-19 testing, including testing costs, visit costs, and overall lack of availability of rapid testing in the majority of UCCs. Despite the passage of the CARES Act, these results suggest that there is room for additional policy to improve accessibility to testing, specifically rapid testing.
为应对疫情，紧急护理中心（UCC）已成为新冠病毒检测的常见地点，发挥着关键作用。我们试图根据检测可用性（包括快速抗原检测）、检测结果等待时间、就诊费用和检测费用，描述2020年3月至8月期间紧急护理中心检测可及性的变化。
采用秘密顾客调查法收集数据。研究人员联系了10个州的250家紧急护理中心。调查人员使用标准化脚本来调查各中心的新冠病毒检测可用性和政策。紧急护理中心最初于3月被联系，8月再次被联系。进行t检验和卡方检验以确定3月和8月数据之间的差异以及按中心分类的差异。
我们的结果表明，用于检测新冠病毒遗传物质的聚合酶链反应（PCR）检测和快速抗原新冠病毒检测的可用性均有所增加。然而，PCR检测结果的等待时间显著增加，平均达到5.79天。此外，很大一部分紧急护理中心继续对检测和就诊收费，从3月到8月，对新冠病毒检测收费的紧急护理中心比例没有显著下降。此外，没有一个州报告大多数紧急护理中心提供快速检测，这表明总体上快速检测缺乏。
从3月到8月，新冠病毒检测的可用性逐渐提高。然而，在新冠病毒检测的可及性方面存在许多障碍，包括检测费用、就诊费用以及大多数紧急护理中心总体上缺乏快速检测。尽管《冠状病毒援助、救济和经济安全法案》（CARES Act）已经通过，但这些结果表明，仍有空间出台更多政策来提高检测的可及性，特别是快速检测。
