PDF(Pubmed)
Abstract：
We examined the impact of the first year of the COVID-19 pandemic on unmet healthcare need among New Yorkers and potential differences by race/ethnicity and health insurance. Data from the Community Health Survey, collected in 2018, 2019, and 2020, were merged to compare unmet healthcare need within the past 12 months during the pandemic versus the 2 years prior to 2020. Univariate and multivariable logistic regression models evaluated change in unmet healthcare need overall, and we assessed whether race/ethnicity or health insurance status modified the association. Overall, 12% of New Yorkers (N = 27,660) experienced unmet healthcare during the 3-year period. In univariate and multivariable models, the first year of the pandemic (2020) was not associated with change in unmet healthcare need compared with 2018-2019 (OR = 1.04, p = 0.548; OR = 1.03, p = 0.699, respectively). There was no statistically significant interaction between calendar year and race/ethnicity, but there was significant interaction with health insurance status (interaction p = 0.009). Stratifying on health insurance status, those uninsured had borderline significant lower odds of experiencing unmet healthcare need during 2020 compared to the 2 years prior (OR = 0.72, p = 0.051) while those with insurance had a slight increase that was not significant (OR = 1.12, p = 0.143). Unmet healthcare need among New Yorkers during the first year of the pandemic did not differ significantly from 2018-2019. Federal pandemic relief funding, which offered no-cost COVID-19 testing and care to all, irrespective of health insurance or legal status, may have helped equalized access to healthcare.
摘要：
我们研究了COVID-19大流行的第一年对纽约人未满足的医疗保健需求的影响，以及种族/民族和医疗保险的潜在差异。来自社区健康调查的数据，将2018年、2019年和2020年收集的医疗需求进行合并，以比较大流行期间过去12个月未满足的医疗需求与2020年之前的2年。单变量和多变量逻辑回归模型评估了未满足的医疗保健需求的总体变化，我们评估了种族/民族或健康保险状态是否改变了这种关联.总的来说,12％的纽约人（N=27,660）在3年期间经历了未满足的医疗保健。在单变量和多变量模型中，与2018-2019年相比,大流行的第一年(2020年)与未满足的医疗保健需求变化无关(分别为OR=1.04,p=0.548;OR=1.03,p=0.699).日历年和种族/民族之间没有统计学上显著的相互作用，但与健康保险状况存在显著交互作用(交互作用p=0.009).对健康保险状况进行分层，与前2年相比,未参保者在2020年期间经历未满足的医疗保健需求的几率显著降低(OR=0.72,p=0.051),而有保险者则略有增加,但不显著(OR=1.12,p=0.143).在大流行的第一年，纽约人未满足的医疗保健需求与2018-2019年没有显着差异。联邦大流行救济资金，为所有人提供免费的COVID-19测试和护理，无论健康保险或法律地位如何，可能有助于均衡获得医疗保健。
