BWH - Brigham and Women's Hospital
05/17/2021 | Press release | Distributed by Public on 05/17/2021 13:30
Amidst Pandemic, Timely Primary Care Remains Accessible: Q&A
The COVID-19 pandemic has put exceptional strain on the U.S. health care system, and many primary care practices, facing financial struggles prior to the public health crisis, have rapidly needed to adapt to new circumstances. Ishani Ganguli, MD, MPH, of the Division of General Internal Medicine and Primary Care, is the senior author on a study now published in the Journal of General Internal Medicine that illuminates the extent to which patients were able to access primary care during the fall of 2020. Ganguli, first author Michael Anne Kyle, MSN, MPH, RN, and co-authors found that when practices were reachable via telephone, median wait times for new appointments were relatively low - 10 days - but that other barriers limiting access to primary care nonetheless persist. They explain their observations below.
Can you describe how you conducted this study? What were your primary findings?
We did a simulated patient study to understand access to primary care during the pandemic. We used online listings from a large commercial insurer in four major cities (Phoenix, Chicago, Boston, and Raleigh/Greensboro) to create a random sample of 800 primary care practices. Our research team called each of these practices to request visits as prospective new patients.
Forty-four percent of practices were unreachable, either because they had closed down or because the listings were inaccurate. Of the practices we reached, the vast majority - 84 percent - offered timely new patient appointments with a median wait time of just 10 days. Most of these practices also offered virtual visit options, through either a telephone call or video visit.
How are primary care practices supporting individuals who suspect they have been infected with COVID-19?
More than half of the practices we reached offered either a clinical consultation or an on-site COVID-19 test as the next step. Less often, we were referred to testing at another location, a COVID-19 hotline, or, rarely, an urgent care or emergency department. Only 2 percent of the practices we reached had no guidance at all.
What barriers does your study suggest may still exist for individuals seeking care?
We found many inaccuracies in patient-facing provider listings, such that only about half of the listed practices were deemed reachable. This likely causes stress for patients and delays access to care. While wait times were low overall, this varied by city - in Boston, the wait time was 24 days.
What role do primary care practices appear to be playing in the COVID-19 pandemic, and how can they best support patients?
We found that primary care practices played an essential role in supporting patients with COVID-19 infections that can be managed at home, with the benefit of off-loading busy emergency departments and hospitals. Efforts to control the pandemic - including through vaccination - should support and take into consideration the central role of primary care practices.