Nearly 30% of women report disrupted health care during pandemic
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More than one in four women reported that the COVID-19 pandemic limited their primary care access, and one in six women reported disruptions to their gynecologic care specifically, survey findings showed.
“During the COVID-19 pandemic, women were more likely to experience employment disruption and additional caregiver burden compared with men,” Kea Turner, PhD, MPH, MA, an assistant professor at the University of South Florida in Tampa, told Healio. “Despite these disparities, there has been limited study of how the pandemic may have affected women’s health care access in the United States.”
Turner and colleagues recruited cisgender women aged 21 to 45 years who were part of a probability-based online panel of 60,000 people. They administered the survey between Feb. 25 and March 24, 2021. Ultimately, 1,285 women responded to the survey, which collected information on sociodemographics, clinical history and prior use of preventive health care, as well as attitudes and knowledge about preventive health care and the impact of the pandemic on health care access.
Primary care access
In total, 355 (28.5%) women reported disruptions to their primary care access. Women identifying as a sexual minority were more likely to report disruptions compared with heterosexual women (OR = 1.67; 95% CI, 1.19-2.33). Women with a history of cancer were also more likely to report disruptions to their primary care access compared with women who had no history of cancer (OR = 2.07; 95% CI, 1.25-3.42).
Some women (n = 129; 10.4%) reported they had no primary care provider. Having a regular source of income, private insurance and having attended a health care visit in the past year were associated with lower odds of not having a primary care provider.
Gynecologic care access
In terms of gynecologic care, 207 (16.7%) women reported that the pandemic disrupted access. Women who had a history of cancer were more likely to report disrupted access compared with those without a cancer history (OR = 2.34; 95% CI, 1.35-4.08).
Additionally, compared with women who attended their last health care visit more than 5 years ago, those who reported their last visit 1 to 2 years ago (OR = 2.83; 95% CI, 1.3-6.15) or 3 to 5 years ago (OR = 2.36; 95% CI, 1.01-5.56) were more likely to report pandemic-related disruptions to their gynecologic care.
Approximately 17% (n = 213) of women reported having no gynecologic care provider. Similar to primary care, women who were married, had private insurance, were up-to-date on cervical cancer screenings, had a higher perceived risk for HPV-related cancer and attended a health care visit in the past year were less likely to report not having a gynecologic health care provider.
Preventive care access
One in four (n = 301; 24.2%) women reported provider-initiated disruptions of preventive care visits, with women identifying as a sexual minority vs. heterosexual more likely to report this type of disruption (OR = 1.58; 95% CI, 1.1-2.28). Women who preferred to receive health information in a language other than English, had a regular source of care and attended a health care visit in the past year were more likely to report provider-initiated disruptions.
One-quarter (n = 329; 26.4%) of women reported that they canceled or delayed their preventive care visits during the pandemic. Women who identified as a sexual minority, had a usual source of care and attended a health care visit in the past year were more likely to cancel or delay their visit.
“Our study findings suggest that additional interventions may be needed to increase the accessibility of primary care and gynecological care for women in the U.S. during the pandemic,” Turner said. “Approaches might include FDA approval of home-based HPV tests, increased telehealth access and increased accessibility of health care (eg, cancer screening through mobile clinics and community pharmacies). Additionally, our findings suggest targeted interventions may be needed for women who were more likely to experience disruptions in health care during the pandemic (eg, sexual minority women and cancer survivors).”
Turner said future research should examine contraception access during the pandemic.