Bronchetti Erin T, Magenheim Ellen B, Bergmann Ethan K
Department of Economics, Swarthmore College, Swarthmore, PA 19081, United States.
Industrial Relations Section, Princeton University, Princeton, NJ 08544, United States.
Health Aff Sch. 2023 Nov 2;1(5):qxad057. doi: 10.1093/haschl/qxad057. eCollection 2023 Nov.
This paper uses data from a new, nationally representative survey to study delays in non-COVID-related medical care among US adults during the COVID-19 pandemic. We expand on prior research by taking a comprehensive look at the many reasons patients may have experienced delays in medical care and by studying the longer-run implications of these delays for patients' self-reported health, use of telemedicine, feelings of regret, and likelihood of delaying care again in the future. Classifying delays in care broadly as involuntary (those due to availability or "supply-side" constraints) or patient-initiated (those due to patient concerns or "demand-side" constraints), we document important differences across demographic groups in the propensity to delay care for these reasons. In contrast to most prior work on this topic, our analyses can disentangle differences in the likelihood of delaying care from differences in pre-pandemic care-seeking behavior. We also demonstrate that the types of medical care that were delayed during the pandemic differed based on whether the delay was involuntary or patient-initiated, as did the duration of the delays and their associations with self-reported health, telemedicine use, and feelings of regret.
本文使用一项新的、具有全国代表性的调查数据，来研究美国成年人在新冠疫情期间非新冠相关医疗护理的延误情况。我们通过全面审视患者可能经历医疗护理延误的诸多原因，并研究这些延误对患者自我报告的健康状况、远程医疗使用情况、遗憾感以及未来再次延误护理可能性的长期影响，对先前的研究进行了拓展。我们将护理延误大致分为非自愿性（因可及性或“供应方”限制导致的延误）或患者主动造成的（因患者担忧或“需求方”限制导致的延误），并记录了不同人口群体因这些原因延误护理倾向的重要差异。与此前关于该主题的大多数研究不同，我们的分析能够区分延误护理可能性的差异与疫情前就医行为的差异。我们还表明，疫情期间延误的医疗护理类型因延误是非自愿性还是患者主动造成的而有所不同，延误的时长以及它们与自我报告的健康状况、远程医疗使用情况和遗憾感的关联也是如此。
