Patients with long COVID report barriers to health care access
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Key takeaways:
- Adults in the U.S. who had long COVID were more likely to report unmet health care needs.
- Cost was the greatest challenge people with long COVID faced.
People with long COVID were more likely to report unmet health care needs in the last year due to challenges like cost and access to care, according to research published in JAMA Network Open.
Many adults in the United States report having long COVID, but not much is known about their access to health care, Michael Karpman, MPP, a research associate at the Urban Institute, a Washington, D.C.-based economic and social policy think tank, and colleagues wrote.
“The experiences of patients with similar and overlapping conditions ... suggest that US patients with long COVID may experience difficulties navigating a fragmented health care system,” they wrote.
Some barriers to care can include:
- high out-of-pocket costs;
- trouble finding available and accessible clinicians;
- clinician attitudes toward or lack of knowledge about the illness;
- denial of health insurance claims for tests and treatments; and
- lack of care coordination.
“The consequences associated with unmet medical needs may include exacerbated risk of disability and reduced health-related quality of life,” the researchers wrote. “Access to timely and effective treatment may be especially important for maintaining employment.”
Karpman and colleagues conducted a survey study to approximate the association of long COVID — defined as experiencing symptoms more than 4 weeks after first having COVID-19 that are not explained by another condition or factor — with affordability and access barriers among U.S. adults aged 18 to 64 years.
The researchers used data from a probability-based internet survey, the Health Reform Monitoring Survey, which was conducted from June 17, 2022, to July 5, 2022. The analysis included a nationally representative sample of 9,484 adults with a mean age of 41 years, 50.6% of whom were women.
Of the respondents, 3,382 reported ever being diagnosed with COVID-19 (36.4%; 95% CI, 34.7-38.2). Among that group, 833 respondents (22.5%; 95% CI, 20.9-24.2) reported currently having long COVID.
After adjusting for differences in health, geographic and demographic characteristics, Karpman and colleagues reported that those with long COVID were more likely than those who had a COVID-19 diagnosis but not long COVID (2,549 participants) and those who were never diagnosed with COVID-19 (6,102 participants) to report unmet health care needs in the last year due to several challenges.
These challenges included:
- costs (27%; 95% CI, 23.2-30.7);
- getting a timely appointment (22%; 95% CI, 19.3-24.8);
- getting health plan care authorization (16.6%; 95% CI, 14.6-18.6); and
- finding clinicians accepting new patients (16.4%; 95% CI, 14.3-18.4);
“These barriers may be associated with adverse outcomes for workforce participation and long-term health,” Karpman and colleagues wrote.
However, policy makers “may be able to expand access to care” by disseminating clinical care guidelines, accelerating research on treatments for long COVID and regulating insurance practices, they concluded.