People with chronic lung diseases more likely to have delayed, avoided care during pandemic
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SAN FRANCISCO — During the COVID-19 pandemic, people with chronic lung diseases, including asthma and COPD, were more likely to delay or avoid medical care compared with the general population or those with other COVID-19 risk factors
At the American Thoracic Society International Conference, Jane C. Fazio, MD, pulmonary critical care fellow at the David Geffen School of Medicine at UCLA, presented results of a cross-sectional secondary analysis of National Health Interview Survey data from the third and fourth quarters of 2020. Among respondents with self-reported asthma and/or COPD, Fazio, along with Russell G. Buhr, MD, PhD, with the department of health policy and management at the Fielding School of Public Health at UCLA, assessed self-reported rates of care delays and avoidance due to the COVID-19 pandemic. The researchers then compared respondents with asthma and/or COPD with those without and respondents with asthma and/or COPD and additionally with those with one or more chronic condition including diabetes (14.2%), hypertension (50%) or cardiac history (8.6%).
Overall, 12,295 respondents reported having asthma and/or COPD (54.1% women). Those with asthma or COPD reported more often delaying (34.1% vs. 27.2%; P < .001) or avoiding (25% vs. 18.2%; P < .001) medical care during the pandemic compared with those without either asthma and/or COPD.
Asthma (OR = 1.45; 95% CI, 1.2-1.8), COPD (OR = 2.13; 95% CI, 1.2-3.7), and asthma and/or COPD (OR = 1.61; 95% CI, 1.1-2.2) were significant risk factors for delaying or avoiding medical care in unadjusted models. However, after adjusting for number of chronic conditions, asthma and/or COPD were no longer significant risk factors (OR = 1.12; 95% CI, 0.95-1.3).
Compared with those with a history of diabetes (n = 1,499), respondents with asthma and/or COPD had higher rates of delayed care (34.3% vs. 29.1%; P = .007) and avoided care (24.1% vs. 19.5%; P = .019).
“A higher number of comorbidities among asthma and COPD patients was more likely to be associated with a burden or delaying medical care during the COVID-19 pandemic, at least in the second half of 2020,” Fazio told Healio.
Fazio said the findings were “robust” and the “marginal effect was great.”
It is estimated that 47% of the U.S. population delayed or avoided medical care during the pandemic, for a variety of reasons.
“This study is pointing out that the most common comorbid patients are at highest risk of not accessing medical care,” Fazio said. “The next step is [to evaluate] if that is associated with patient outcomes, which this data set doesn’t have the information to describe.”
The researchers said further research is needed to determine the health impact of delayed and avoided medical care, as well as determine innovative solutions in telehealth to prevent future care disruptions.