Many Americans with long-term COVID have trouble accessing care
WEDNESDAY, April 12, 2023 (HealthDay News) — Getting care in the United States for persistent symptoms of COVID-19 can be difficult, affecting long-term health and the ability to work, a new study finds.
Adults with what is known as long-term COVID have had greater difficulties with access to and affordability of health care than other adults, and these barriers to care have implications for their well-being, said the lead researcher, Michael Karpmanresearch associate at the Urban Institute’s Center for Health Policy, in Washington, DC
“More efforts are needed to develop treatments for prolonged COVID, provide guidance for clinicians, and set standards to define medically necessary care and other insurer practices to reduce delays in access to testing and the treatments,” he said.
Part of the problem is that there are no standard diagnostic tests and treatments for long-term COVID, Karpman said.
“Providers may not have enough information on how to address a patient’s problems. This could lead them to perform unnecessary tests or make inappropriate referrals. Without clear standards of care, insurers may deny payment for some services,” he said.
The research team defined prolonged COVID as having symptoms beyond four weeks.
Karpman and his colleagues collected data from nearly 9,500 US men and women, ages 18 to 64, who participated in an online survey that was conducted from June 17 to July 5, 2022.
36 percent said they had recently been diagnosed with COVID-19, and 22.5 percent said they had long-term COVID.
The researchers found that those with long-term COVID were less likely to receive the health care they needed than those who had COVID, but not long-term COVID, or those who had never had the virus.
Nearly 3 in 10 (27 percent) said that cost prevented them from getting the care they needed. Finding a doctor who is accepting new patients was a problem for 16 percent of people with long-term COVID, while 22 percent said they were unable to get a timely appointment. Insurance obstacles prevented nearly 17 percent from receiving prescription care or drugs, Karpman’s team found.
There are differences in the demographics of adults with long-term COVID, but after controlling for these differences, all long-term COVID patients are still more likely to have access difficulties, Karpman said.
Staci Lofton, senior director of health equity for Families USA, which advocates for access to health care, noted that poor and minority people are bearing the brunt of prolonged COVID. Getting Supplemental Security Income (SSI) from Social Security has become very difficult, she said.
“There are a growing number of people who are applying for SSI due to prolonged COVID, but depending on their state’s requirements, they may not qualify for Medicaid or simply may not have the support of social resources to guide them through the process,” she said. Lofton, who was not involved in the study.
The system works to discourage individuals from applying, he said.
“We’re not even prepared to address long-term COVID as a disability, or the stigma that comes with it, given the populations that are most impacted by COVID. Additionally, Black and brown communities, the same communities most likely to need care for long-term prolonged COVID, they are more likely to be in an area where the demand for care is not being met well,” Lofton said.
Karpman argued that to address these issues, it is necessary to accelerate research on long-term COVID, launch clinical trials on potential treatments, and develop clinical guidelines. Collecting data on claims for prolonged COVID-related care will help paint a clearer picture, she said.
Arielle Kanedirector of Medicaid initiatives for Families USA, cited another problem people with persistent COVID have: “People with long-term COVID are more likely to be working fewer hours after their infection than those without long-term COVID. This affects both to their cash flow and their health insurance status: those who work less are more likely to be uninsured.”
Kane, who was not involved in the study, said standards of care should be developed as more clinical data becomes available.
“On the other hand,” he clarified, “people with complex conditions often need help navigating their coverage, finding in-network providers, and appealing denials of care. This type of consumer assistance should be readily available broader, and should reach people who speak Spanish, English, and other languages People also need better access to long-term COVID clinics.
“This problem is not going to go away,” Kane added. “Maybe it’s time to figure out how to integrate long-term COVID into the medical school curriculum.”
The report was published in the April 10 online edition of the journal JAMA Network Open.
More information
Los US Centers for Disease Control and Prevention. offer more information on prolonged COVID.
Article by HealthDay, translated by HolaDoctor.com
FUENTES: Michael Karpman, MPP, Health Policy Center, Urban Institute, Washington, D.C.; Staci Lofton, MPH, JD, senior director, Health Equity, Families USA, Washington, D.C.; Arielle Kane, MS, director, Medicaid Initiatives, Families USA, Washington, D.C.; JAMA Network OpenApril 10, 2023, online
