Differential care-seeking behaviors during the beginning of the COVID-19 pandemic in Michigan: a population-based cross-sectional study
Abstract Background At the beginning of the COVID-19 pandemic in the United States in the spring of 2020, many Americans avoided the healthcare system, while those with COVID-19 symptoms were faced with decisions about seeking healthcare services for this novel virus. Methods Using a probability sam...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12889-023-16999-5 |
| _version_ | 1797555936752041984 |
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| author | Catherine A. Vander Woude Elizabeth J. King Jana L. Hirschtick Andrea R. Titus Laura E. Power Michael R. Elliott Nancy L. Fleischer |
| author_facet | Catherine A. Vander Woude Elizabeth J. King Jana L. Hirschtick Andrea R. Titus Laura E. Power Michael R. Elliott Nancy L. Fleischer |
| author_sort | Catherine A. Vander Woude |
| collection | DOAJ |
| description | Abstract Background At the beginning of the COVID-19 pandemic in the United States in the spring of 2020, many Americans avoided the healthcare system, while those with COVID-19 symptoms were faced with decisions about seeking healthcare services for this novel virus. Methods Using a probability sample (n = 1088) from the Michigan adult population of PCR-confirmed COVID-19 cases who were diagnosed prior to July 31, 2020, we used logistic regression to examine sociodemographic and symptom severity predictors of care-seeking behaviors. The analyses examined three different outcomes: (1) whether respondents sought care and, among those who sought care, whether they sought care from (2) a primary care provider or (3) an emergency room. Final models were adjusted for sex, age, race and ethnicity, income, education, marital status, living arrangement, health insurance, and self-reported symptom severity. Results We found that participants ages 65 and older had 4.00 times higher odds of seeking care than 18-34-year-olds (95% CI: 2.21, 7.24), while adults reporting very severe symptoms had roughly 15 times higher odds of seeking care than those with mild symptoms (95% CI: 7.73, 27.01). Adults who were non-Hispanic Black or were uninsured had lower odds of seeking care from a primary care physician versus seeking care from other locations in comparison to adults who were non-Hispanic White or were privately insured, respectively (non-Hispanic Black: aOR = 0.27, 95% CI: 0.16, 0.44; Uninsured: aOR = 0.19, 95% CI: 0.09, 0.42). Conversely, adults who were older or reported more severe symptoms had higher odds of seeking care from an emergency room versus other locations in comparison to adults who were younger or reported less severe symptoms (Age 65+: aOR = 2.96, 95% CI: 1.40, 6.28; Very Severe Symptoms: aOR = 6.63, 95% CI: 3.33, 13.20). Conclusions Our results suggest differential utilization of healthcare services early in the COVID-19 pandemic. Further analyses are needed to examine the reasons for these differences. |
| first_indexed | 2024-03-10T16:55:38Z |
| format | Article |
| id | doaj.art-28530bf93f6b4fed84d9f0bdb416e8a9 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-03-10T16:55:38Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-28530bf93f6b4fed84d9f0bdb416e8a92023-11-20T11:09:04ZengBMCBMC Public Health1471-24582023-10-0123111210.1186/s12889-023-16999-5Differential care-seeking behaviors during the beginning of the COVID-19 pandemic in Michigan: a population-based cross-sectional studyCatherine A. Vander Woude0Elizabeth J. King1Jana L. Hirschtick2Andrea R. Titus3Laura E. Power4Michael R. Elliott5Nancy L. Fleischer6Department of Epidemiology, University of Michigan School of Public HealthDepartment of Health Behavior and Health Education, University of Michigan School of Public HealthDepartment of Epidemiology, University of Michigan School of Public HealthDepartment of Population Health, Grossman School of Medicine, New York UniversityDepartment of Epidemiology, University of Michigan School of Public HealthDepartment of Biostatistics, University of Michigan School of Public HealthDepartment of Epidemiology, University of Michigan School of Public HealthAbstract Background At the beginning of the COVID-19 pandemic in the United States in the spring of 2020, many Americans avoided the healthcare system, while those with COVID-19 symptoms were faced with decisions about seeking healthcare services for this novel virus. Methods Using a probability sample (n = 1088) from the Michigan adult population of PCR-confirmed COVID-19 cases who were diagnosed prior to July 31, 2020, we used logistic regression to examine sociodemographic and symptom severity predictors of care-seeking behaviors. The analyses examined three different outcomes: (1) whether respondents sought care and, among those who sought care, whether they sought care from (2) a primary care provider or (3) an emergency room. Final models were adjusted for sex, age, race and ethnicity, income, education, marital status, living arrangement, health insurance, and self-reported symptom severity. Results We found that participants ages 65 and older had 4.00 times higher odds of seeking care than 18-34-year-olds (95% CI: 2.21, 7.24), while adults reporting very severe symptoms had roughly 15 times higher odds of seeking care than those with mild symptoms (95% CI: 7.73, 27.01). Adults who were non-Hispanic Black or were uninsured had lower odds of seeking care from a primary care physician versus seeking care from other locations in comparison to adults who were non-Hispanic White or were privately insured, respectively (non-Hispanic Black: aOR = 0.27, 95% CI: 0.16, 0.44; Uninsured: aOR = 0.19, 95% CI: 0.09, 0.42). Conversely, adults who were older or reported more severe symptoms had higher odds of seeking care from an emergency room versus other locations in comparison to adults who were younger or reported less severe symptoms (Age 65+: aOR = 2.96, 95% CI: 1.40, 6.28; Very Severe Symptoms: aOR = 6.63, 95% CI: 3.33, 13.20). Conclusions Our results suggest differential utilization of healthcare services early in the COVID-19 pandemic. Further analyses are needed to examine the reasons for these differences.https://doi.org/10.1186/s12889-023-16999-5COVID-19Access to careHealthcare utilization |
| spellingShingle | Catherine A. Vander Woude Elizabeth J. King Jana L. Hirschtick Andrea R. Titus Laura E. Power Michael R. Elliott Nancy L. Fleischer Differential care-seeking behaviors during the beginning of the COVID-19 pandemic in Michigan: a population-based cross-sectional study BMC Public Health COVID-19 Access to care Healthcare utilization |
| title | Differential care-seeking behaviors during the beginning of the COVID-19 pandemic in Michigan: a population-based cross-sectional study |
| title_full | Differential care-seeking behaviors during the beginning of the COVID-19 pandemic in Michigan: a population-based cross-sectional study |
| title_fullStr | Differential care-seeking behaviors during the beginning of the COVID-19 pandemic in Michigan: a population-based cross-sectional study |
| title_full_unstemmed | Differential care-seeking behaviors during the beginning of the COVID-19 pandemic in Michigan: a population-based cross-sectional study |
| title_short | Differential care-seeking behaviors during the beginning of the COVID-19 pandemic in Michigan: a population-based cross-sectional study |
| title_sort | differential care seeking behaviors during the beginning of the covid 19 pandemic in michigan a population based cross sectional study |
| topic | COVID-19 Access to care Healthcare utilization |
| url | https://doi.org/10.1186/s12889-023-16999-5 |
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