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. 2021 Jan-Dec:12:21501319211069473.
doi: 10.1177/21501319211069473.

Early Data on Predictors of COVID-19 Treatment Frequency at Community Health Centers

Evan V Goldstein  1 , Eric E Seiber  2
Affiliations

Early Data on Predictors of COVID-19 Treatment Frequency at Community Health Centers

Evan V Goldstein et al. J Prim Care Community Health. 2021 Jan-Dec.

Abstract

Introduction: Federally-funded community health centers (CHCs) serve on the front lines of the COVID-19 pandemic, providing essential COVID-19 testing and care for vulnerable patient populations. Overlooked in the scholarly literature is a description of how different characteristics and vulnerabilities shaped COVID-19 care delivery at CHCs in the first year of the pandemic. Our research objective was to identify organization- and state-level factors associated with more or fewer COVID-19 care and testing visits at CHCs in 2020.

Methods: Multilevel random intercept regression models examined associations among organization and state-level predictor variables and the frequency of COVID-19 care and testing visits at CHCs in 2020. The study sample included 1267 CHCs across the 50 states and the District of Columbia.

Results: The average CHC provided 932 patient visits for COVID-19-related care in 2020. Yet, the CHC's role in delivering COVID-19 services proved as diverse as the populations and localities CHCs serve. For example, after adjusting for other factors, each percentage-point increase in a CHC's Hispanic patient population size was associated with a 1.3% increase in the frequency of patient visits for COVID-19 care in 2020 (P < .001). Serving a predominantly rural patient population was associated with providing significantly fewer COVID-19-related care visits (P = .002). Operating in a state that enacted a mask-wearing policy in 2020 was associated with a 26.2% lower frequency of COVID-19 testing visits at CHCs in 2020, compared to CHCs operating in states without mask-wearing policies (P = .055).

Conclusions: In response to the pandemic, the federal government legislated funding to help CHCs address challenges associated with COVID-19 and provide services to medically-underserved patient populations. Policymakers will likely need to provide additional support to help CHCs address population-specific vulnerabilities affecting COVID-19 care and testing delivery, especially as highly contagious COVID-19 variants proliferate (eg, Delta and Omicron).

Keywords: COVID-19; community health; primary care; vulnerable populations.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

    1. Goldstein EV. Community health centers maintained initial increases in medicaid covered adult patients at 5-years post-medicaid-expansion. Inquiry. 2021;58(1):1-10. doi:10.1177/00469580211022618 - PMC - PubMed
    1. Sardell A. The U.S. Experiment in Social Medicine: The Community Health Center Program, 1965-1986. University of Pittsburgh Press; 1989.
    1. National Association of Community Health Centers. Health centers on the front lines of covid-19: $7.6 billion in lost revenue and devastating impact on patients and staff. 2020. Accessed August 20, 2021. https://www.nachc.org/wp-content/uploads/2020/04/Financial-Loss-Fact-She...
    1. Capital Link. Financial impact of COVID-19 on federally qualified health centers. 2021. Accessed August 20, 2021. https://www.caplink.org/images/National_COVID-19_Infographic_-_UPDATED_F...
    1. HRSA. Uniform Data System (UDS) resources. Published 2020. Accessed August 20, 2021. https://bphc.hrsa.gov/datareporting/reporting/index.html

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Supplementary concepts