Abstract

Temporary disruptions in routine and nonemergency medical care access and delivery have been observed during periods of considerable community transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19) (1). However, medical care delay or avoidance might increase morbidity and mortality risk associated with treatable and preventable health conditions and might contribute to reported excess deaths directly or indirectly related to COVID-19 (2). To assess delay or avoidance of urgent or emergency and routine medical care because of concerns about COVID-19, a web-based survey was administered by Qualtrics, LLC, during June 24-30, 2020, to a nationwide representative sample of U.S. adults aged ≥18 years. Overall, an estimated 40.9% of U.S. adults have avoided medical care during the pandemic because of concerns about COVID-19, including 12.0% who avoided urgent or emergency care and 31.5% who avoided routine care. The estimated prevalence of urgent or emergency care avoidance was significantly higher among the following groups: unpaid caregivers for adults* versus noncaregivers (adjusted prevalence ratio [aPR] = 2.9); persons with two or more selected underlying medical conditions<sup>†</sup> versus those without those conditions (aPR = 1.9); persons with health insurance versus those without health insurance (aPR = 1.8); non-Hispanic Black (Black) adults (aPR = 1.6) and Hispanic or Latino (Hispanic) adults (aPR = 1.5) versus non-Hispanic White (White) adults; young adults aged 18-24 years versus adults aged 25-44 years (aPR = 1.5); and persons with disabilities<sup>§</sup> versus those without disabilities (aPR = 1.3). Given this widespread reporting of medical care avoidance because of COVID-19 concerns, especially among persons at increased risk for severe COVID-19, urgent efforts are warranted to ensure delivery of services that, if deferred, could result in patient harm. Even during the COVID-19 pandemic, persons experiencing a medical emergency should seek and be provided care without delay (3).

Keywords

MedicineCoronavirus disease 2019 (COVID-19)2019-20 coronavirus outbreakSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2)BetacoronavirusMEDLINEPandemicCoronavirus InfectionsFamily medicineMedical emergencyEnvironmental healthVirologyOutbreakPathologyInfectious disease (medical specialty)Disease

MeSH Terms

AdolescentAdultAgedCOVID-19Coronavirus InfectionsFemaleHumansMaleMiddle AgedPandemicsPneumoniaViralTime-to-TreatmentTreatment RefusalUnited StatesYoung Adult

Related Publications

Publication Info

Year
2020
Type
article
Volume
69
Issue
36
Pages
1250-1257
Citations
1479
Access
Closed

Social Impact

Social media, news, blog, policy document mentions

Citation Metrics

1479
OpenAlex
50
Influential
1241
CrossRef

Cite This

Mark É. Czeisler, Kristy Marynak, Kristie E.N. Clarke et al. (2020). Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020. MMWR Morbidity and Mortality Weekly Report , 69 (36) , 1250-1257. https://doi.org/10.15585/mmwr.mm6936a4

Identifiers

DOI
10.15585/mmwr.mm6936a4
PMID
32915166
PMCID
PMC7499838

Data Quality

Data completeness: 86%