Community Health and Family Medicine 2020 Projects

Project Title: COVID-19 Era Health Care Service Utilization and Relevant Patient Health Occurrences and Outcomes

Faculty Mentor’s Name: Maribeth Williams

Student Name: Del Carter 

Research Project Description:

The first cases of COVID-19 in Florida were confirmed March 1, 2020 (Mower, 2020). With the ensuing changes in daily life, general public fear of contracting the virus, and health care organization policy changes, the deliverance and utilization of primary care has undoubtedly been affected. Given primary care’s position as a gateway to the health care system and its ability to handle medical problems before they require a higher level of care (Starfield, Shi, & Macinko, 2005), any disruption in primary care utilization and the subsequent impacts of these changes are a cause for concern. Moreover, in considering primary care as comparatively having greater equity than more advanced and specialized services in the health care system (Starfield, Shi, & Macinko, 2005), the possibility for an exacerbation of health disparities exists in the wake of COVID-19 primary care disruptions.

Past work has associated increased emergency department (ED) use with both greater barriers to prompt primary care (Cheung, Wiler, Lowe, & Ginde, 2012) and lower levels of primary care continuity (Ionescu-Ittu, et al., 2007). Additionally, increased primary care access has been associated with decreased preventable hospitalizations for certain conditions (Bindman, et al., 1995), as well as the actual utilization of primary care with improved health outcomes (Starfield, Shi, & Macinko, 2005). Lastly, even temporary disruptions in access to primary care, such as in the case of Superstorm Sandy, have been linked with negative impacts on patient health (Baum, Barnett, Wisnivesky, & Schwartz, 2019).

With the importance of primary care on patient health and the utilization of other health care services, changes in primary care delivery and utilization in the COVID-19 era warrant further consideration to more fully understand the associated impacts and consequences.