The differential impact of the COVID-19 pandemic on healthcare utilization disruption for community-dwelling individuals with and without acquired brain injury.
Academic Article
Overview
abstract
Objective: To delineate healthcare disruption for individuals with (ABI) during the peak of the pandemic, and to understand the impact of healthcare disruption on health-related quality of life (HRQoL). Design: Cross-sectional survey. Setting: General community. Participants: N=207. Volunteer sample of adults with traumatic brain injury (TBI, n=33), stroke (n=66), and healthy adults (n=108) with access to the internet and personal technology. Interventions: NA. Main Outcome Measures: NA. Results: Participants with TBI and stroke reported high rates of disruption in care specific to their diagnosis (53-54.5%), while participants across all groups reported disruption for major medical care (ranging from 68.2-80%), general healthcare (ranging from 60.3-72.4%), and mental healthcare (ranging from 31.8-83.3%). During the pandemic, participants with TBI and stroke used telehealth for care specific to their diagnosis (40.9-42.4%), while all participants used telehealth for major medical care (ranging from 50-86.7%), general healthcare (ranging from 31.2-53.3%), and mental healthcare (ranging from 53.8-72.7%). Disruption in TBI/stroke care and type of ABI explained 27.1% of the variance in HRQoL scores (F (2, 95) = 16.82, p<.001, R2 = 0.262), and disruption in mental healthcare explained 14.8% of the variance (F (1, 51) = 8.86, p = 0.004, R2 = 0.148). Conclusion: Individuals with and without ABI experienced pronounced disruption in healthcare utilization overall. However, individuals who experienced a disruption in care specific to TBI or mental healthcare were most vulnerable to decreased HRQoL. Telehealth was a viable alternative to in-person visits for individuals with and without ABI, but, limitations included difficulty with technology, difficulty with comprehensive exam, and decreased rapport with providers.
