背景:检查访问(即,一般健康检查)可以增加预防性服务的完成,并改善对新慢性病的治疗。在COVID-19大流行爆发后,在许多接受安全网护理的群体中,预防性服务完成率下降.
目的:研究与联邦医疗中心(FQHC)患者体检相关的潜在益处。
方法:回顾性队列研究,从2018年3月到2022年2月。
方法:伊利诺伊州七个FQHC的成年人。
方法:两年基线期间的检查(即,前COVID-19)期和两年COVID-19期。
方法:主要结果是完成COVID-19期检查。次要结果是:乳房X线照相术完成;四种常见慢性疾病的新诊断(高血压,糖尿病,抑郁症,或高胆固醇),以及开始使用慢性病药物。
结果:在106,114名患者中,种族/族裔最常见的是拉丁裔/西班牙裔(42.1%)或非西班牙裔黑人(30.2%).大多数患者有医疗补助保险(40.4%)或没有保险(33.9%)。虽然21.0%的患者在基线期间完成了检查,在COVID-19期间,只有15.3%的人这样做。在多元回归分析中,私人保险(相对于医疗补助)与COVID-19期间检查完成情况呈正相关(调整后相对风险[ARR],1.15;95%置信区间,[CI],1.10-1.19),而非西班牙裔黑人种族/种族(相对于拉丁裔/西班牙裔)与检查完成呈负相关(aRR,0.89;95%CI,0.85-0.93)。在次要结果分析中,COVID-19期检查完成与乳房X线照相术概率增加61%相关(aRR,1.61;95%CI,1.52-1.71),诊断的可能性高得多,和治疗开始,所有四种慢性疾病。在探索性相互作用分析中,在一些较年轻的年龄组(与年龄≥65岁相比),检查完成与高血压和高胆固醇的诊断和治疗更适度相关.
结论:在这个大型FQHC队列中,大流行期间,检查完成情况明显下降。检查完成与预防性服务完成相关,慢性疾病检测,并开始慢性病治疗。
BACKGROUND: Checkup visits (i.e., general health checks) can increase preventive service completion and lead to improved treatment of new chronic illnesses. After the onset of the COVID-19 pandemic, preventive service completion decreased in many groups that receive care in safety net settings.
OBJECTIVE: To examine potential benefits associated with checkups in federally qualified health center (FQHC) patients.
METHODS: Retrospective cohort
study, from March 2018 to February 2022.
METHODS: Adults at seven FQHCs in Illinois.
METHODS: Checkups during a two-year Baseline (i.e., pre-COVID-19) period and two-year COVID-19 period.
METHODS: The primary outcome was COVID-19 period checkup completion. Secondary outcomes were: mammography completion; new diagnoses of four common chronic illnesses (hypertension, diabetes, depression, or high cholesterol), and; initiation of chronic illness medications.
RESULTS: Among 106,114 included patients, race/ethnicity was most commonly Latino/Hispanic (42.1%) or non-Hispanic Black (30.2%). Most patients had Medicaid coverage (40.4%) or were uninsured (33.9%). While 21.0% of patients completed a checkup during Baseline, only 15.3% did so during the COVID-19 period. In multivariable regression analysis, private insurance (versus Medicaid) was positively associated with COVID-19 period checkup completion (adjusted relative risk [aRR], 1.15; 95% confidence interval, [CI], 1.10-1.19), while non-Hispanic Black race/ethnicity (versus Latino/Hispanic) was inversely associated with checkup completion (aRR, 0.89; 95% CI, 0.85-0.93). In secondary outcome analysis, COVID-19 period checkup completion was associated with 61% greater probability of mammography (aRR, 1.61; 95% CI, 1.52-1.71), and significantly higher probability of diagnosis, and treatment initiation, for all four chronic illnesses. In exploratory interaction analysis, checkup completion was more modestly associated with diagnosis and treatment of hypertension and high cholesterol in some younger age groups (versus age ≥ 65).
CONCLUSIONS: In this large FQHC cohort, checkup completion markedly decreased during the pandemic. Checkup completion was associated with preventive service completion, chronic illness detection, and initiation of chronic illness treatment.