October 13, 2021
Patient Engagement Hit
By Sara Heath
Although telehealth has filled in some gaps, families still report challenges with patient care access and a preference for in-person care.
About one in five households have faced patient care access issues in the past few months, and among them, about three-quarters saw negative health consequences because of it, according to new data from Robert Wood Johnson Foundation, Harvard T.H. Chan School of Public Health, and NPR.
The report, which looks at overall lifestyle and finance impacts from COVID-19, underscores the unequal experiences low-income families are having even at this point 18 months into the pandemic. Additional findings show 38 percent of households experiencing dire financial straits, even though two-thirds have gotten government-funded financial assistance in the last year.
Families most affected by COVID-19’s social determinants of health impacts trended low-income and were more likely to be Black, Latinx, or of Indigenous descent, reflecting the pandemic’s racial health disparities.
“While Americans have widely received help from the government during the COVID-19 outbreak, millions are still having very serious problems with their finances, healthcare, and their children’s education,” Robert J. Blendon, co-director of the survey and Richard L. Menschel Professor of Public Health and Professor of Health Policy and Political Analysis Emeritus at Harvard T.H. Chan School of Public Health, said in a press release.
“These problems are concentrated in families who earn less than $50,000 a year, with millions of households who have lost their savings and have nothing to fall back on.”
Overall, 18 percent of survey respondents said they or someone in their household had patient care access struggles within the past few months. These people said they were unable to access healthcare when they truly needed it, and of them, three-quarters (76 percent) ultimately faced negative health and wellness consequences.
Of those with patient care access challenges, 78 percent said they had health insurance, while the remaining 22 percent said they did not have health payer coverage. This trend indicates that health insurance access is not necessarily a factor in patient care access challenges; rather, patients face high healthcare costs even with coverage, as well as a barrage of other social barriers that kept them from care.
Seventeen percent of households told the poll that they had trouble affording their healthcare, including 28 percent of households with annual incomes under $50,000. Fifty percent of households without health payer coverage said they had healthcare affordability problems, while 13 percent with insurance said the same.
Said otherwise, one in 10 families paying into health insurance still has healthcare affordability problems.
Telehealth has been somewhat of a help throughout the pandemic, with many healthcare organizations deploying the technology in March and April 2020 to circumvent primary care clinic closures. Since then, healthcare organizations have opened up to get patients back into the physical clinic office, but the RWJF data showed 42 percent of American households are still using telehealth to get care.
Patients are generally happy with telehealth, with 82 percent of families telling the poll they are satisfied with the care or advice they have received via telehealth. That said, 64 percent of families still said they would have preferred an in-person medical visit.
The RWJF data dove into a number of areas of everyday life, uncovering housing issues and deep financial strain external of healthcare need. A quarter of respondents said their work situation—ranging from work satisfaction to actual employment—has gotten worse since the pandemic, a trend that can perhaps be linked to the 38 percent of families still having tight pocketbooks.
Equal proportions of respondents said they are having trouble affording their mortgage/rent and their groceries, coming in at 14 percent. Housing and food security are critical social determinants of health that can have a direct impact on patient wellness, both of which became exacerbated when the COVID-19 pandemic began in March 2020.
The RWJF polling indicates that these SDOH are still top-of-mind for Americans and should be top-of-mind for the healthcare organizations that care for them.
“Over the course of the COVID-19 pandemic, Black, Latino and Indigenous people have been disproportionately impacted in terms of infection, hospitalization and death,” Richard Besser, RWJF’s president and CEO, said in a statement.
“The same is true when it comes to financial hardship. While federal economic assistance has helped millions of families, short-term help is not enough to solve deeply entrenched inequities. Our policy choices—from universal healthcare and paid leave to nutrition assistance and housing supports—must reflect a long-term commitment to a fairer, healthier, and more equitable nation.”
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