Department of Oncological Sciences, University of South Florida Morsani College of Medicine, Tampa, Florida, USA.
Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA.
J Womens Health (Larchmt). 2022 Dec;31(12):1690-1702. doi: 10.1089/jwh.2022.0128. Epub 2022 Oct 31.
There has been limited study of how the COVID-19 pandemic has affected women's health care access. Our study aims to examine the prevalence and correlates of COVID-19-related disruptions to (1) primary care; (2) gynecologic care; and (3) preventive health care among women. We recruited 4,000 participants from a probability-based online panel. We conducted four multinomial logistic regression models, one for each of the study outcomes: (1) primary care access; (2) gynecologic care access; (3) patient-initiated disruptions to preventive visits; and (4) provider-initiated disruptions to preventive visits. The sample included 1,285 women. One in four women (28.5%) reported that the pandemic affected their primary care access. Sexual minority women (SMW) (odds ratios [OR]: 1.67; 95% confidence intervals [CI]: 1.19-2.33) had higher odds of reporting pandemic-related effects on primary care access compared to women identifying as heterosexual. Cancer survivors (OR: 2.07; 95% CI: 1.25-3.42) had higher odds of reporting pandemic-related effects on primary care access compared to women without a cancer history. About 16% of women reported that the pandemic affected their gynecologic care access. Women with a cancer history (OR: 2.34; 95% CI: 1.35-4.08) had higher odds of reporting pandemic-related effects on gynecologic care compared to women without a cancer history. SMW were more likely to report patient- and provider-initiated delays in preventive health care. Other factors that affected health care access included income, insurance status, and having a usual source of care. The COVID-19 pandemic disrupted women's health care access and disproportionately affected access among SMW and women with a cancer history, suggesting that targeted interventions may be needed to ensure adequate health care access during the COVID-19 pandemic.
关于 COVID-19 大流行如何影响妇女获得医疗保健的研究有限。我们的研究旨在调查 COVID-19 对以下方面的影响:(1)初级保健;(2)妇科保健;(3)妇女的预防保健:(1)初级保健的获取;(2)妇科保健的获取;(3)患者主动中断预防就诊;(4)提供者主动中断预防就诊。我们从基于概率的在线小组中招募了 4000 名参与者。我们进行了四项多项逻辑回归模型,每项研究结果一个:(1)初级保健的获取;(2)妇科保健的获取;(3)患者主动中断预防就诊;(4)提供者主动中断预防就诊。该样本包括 1285 名女性。四分之一的女性(28.5%)报告说大流行影响了她们的初级保健获取。性少数女性(SMW)(比值比[OR]:1.67;95%置信区间[CI]:1.19-2.33)与异性恋女性相比,报告大流行对初级保健获取有更大影响的可能性更高。癌症幸存者(OR:2.07;95%CI:1.25-3.42)与没有癌症史的女性相比,报告大流行对初级保健获取有更大影响的可能性更高。约 16%的女性报告说大流行影响了她们的妇科保健获取。有癌症史的女性(OR:2.34;95%CI:1.35-4.08)与没有癌症史的女性相比,报告大流行对妇科保健有更大影响的可能性更高。SMW 更有可能报告患者和提供者主动延迟预防保健。其他影响医疗保健获取的因素包括收入、保险状况和有常规医疗来源。COVID-19 大流行扰乱了妇女获得医疗保健的机会,并且不成比例地影响了 SMW 和有癌症史的妇女的机会,这表明在 COVID-19 大流行期间可能需要有针对性的干预措施来确保获得足够的医疗保健。