Disruptions in Care and Support for Homebound Adults in Home-Based Primary Care in New York City During the COVID-19 Pandemic.
Alex D Federman, Bruce Leff, Abraham A Brody and 4 others
PMID 34190705WHAT IT FOUND
Homebound older adults in home-based primary care reported more difficulty accessing medical care, food, and paid caregivers during the pandemic.
Black participants were more likely than White and Hispanic participants to report medical care access problems.
Key findings
01Compared with pre-pandemic experiences, 31.9% said accessing medical care was more difficult.
02Disruptions in the home included greater difficulty accessing paid caregivers (13.9%) and food (35.3%) than before the pandemic, plus unaddressed household chores (laundry, 81.4%; food preparation, 11.4%).
03Black study participants were more likely than White and Hispanic participants to report disruptions in accessing medical care (13 [50.0%] vs. 3 [14.3%] vs. 6 [27.3%], p=0.02), as well as food preparation and medication taking.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for RNs
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What it does not show
The analysis was based on 70 respondents from 147 potential participants, so many were unreachable or declined. All participants were already receiving home-based primary care in one New York City program, so findings may not apply to homebound adults without such care. Responses were self-reported or proxy-reported by telephone, and 22 of 70 respondents were proxies. The study reported patient experiences, not health outcomes or tested interventions.
Declared interests
The authors are investigators and an advisor to the parent randomized trial of home-based primary care. Dr. Leff reports stock ownership (Koko, Medzed, Honor, Dispatch Health), personal fees (Health Affairs, Medically Home, Kenes, American Board of Internal Medicine), and past presidency and board membership of the American Academy of Home Care Medicine.
The easy way to misread this
Do not conclude that home-based primary care prevented care disruptions. The study surveyed people already receiving home-based primary care in one New York City program, and the authors note they may represent the tip of the iceberg for homebound adults.