Patient-reported factors associated with avoidance of in-person care during the COVID-19 pandemic: Results from a national survey

There has been a substantial decline in in-person care in inpatient and outpatient settings during the ongoing COVID-19 pandemic. Avoidance of needed in-person care may contribute to an avoidable decline in patient health and an increase in mortality. While several systems and behavioral theories ha...

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Bibliographic Details
Published in:PloS one 2022-08, Vol.17 (8), p.e0272609-e0272609
Main Authors: Arnetz, Bengt B, Goetz, Courtney, vanSchagen, John, Baer, William, Smith, Stacy, Arnetz, Judith E
Format: Article
Language:English
Subjects:
Avoidance
Behavior
Care and treatment
Censuses
Chronic illnesses
Communication
Coronaviruses
COVID-19
Demographics
Ecological models
Emergency medical care
Engineering and Technology
Epidemics
Gender identity
Health care
Health care policy
Health insurance
Heart attacks
Hospitals
Infections
Medical care
Medicare
Medicine and Health Sciences
Organizational aspects
Pandemics
Patient admissions
Patients
Pediatrics
Polls & surveys
Regression analysis
Research and Analysis Methods
Safety
Social aspects
Social distancing
Social Sciences
Stroke
Telemedicine
United States
Utilization
Variables
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Summary:There has been a substantial decline in in-person care in inpatient and outpatient settings during the ongoing COVID-19 pandemic. Avoidance of needed in-person care may contribute to an avoidable decline in patient health and an increase in mortality. While several systems and behavioral theories have been put forward to explain the decline, there is a lack of studies informed by patients' own experiences. The current study applied a socio-ecological model encompassing patient, environmental, and institutional-related variables to examine patient-reported factors associated with avoidance of in-person care. Between October and December 2020, a total of 3840 persons responded to a nationwide online questionnaire that was administered using ResearchMatch and Facebook. Self-reported avoidance of in-person care among those who needed it was the main outcome. Multivariable logistic regression analysis was used to identify factors associated with avoidance of needed care. Out of a total of 3372 respondents who reported that they needed in-person care during the early phase of the pandemic, 257 (7.6%) avoided it. Patient-related variables associated with avoiding needed care included younger age (odds ratio (OR), 1.46, 95% CI 1.11 to 1.94, p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0272609