From birth control to mammograms, many women lost preventive care throughout 2020


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The COVID-19 pandemic left many women out of time for major health appointments, according to a new study, and many did not return on time even after clinics reopened. The effect may have been greater in areas where this attention is already falling behind expert recommendations.

The study, conducted by health researchers at the University of Michigan Institute of Health Policy and Innovation, examines tests for breast cancer, cervical cancer and sexually transmitted infections (STIs), as well as two types of contraceptive care: prescriptions of oral contraceptives and insertions of longer-acting devices.

For the whole of 2020, covered by Michigan’s largest private health insurer were 20% to 30% less likely to receive these services than in 2019, according to findings published in JAMA Health Forum.

As expected, there was a sharp drop in most of this attention during Michigan’s first pandemic peak in March and April 2020. This includes the weeks when state public health orders went stop all non-essential healthcare and closed many health clinics to reduce the risk of coronavirus transmission and free health care providers from the rise of a new disease caused by a little-known virus.

But even after the clinics reopened, the rest of the year did not increase these services to make up for lost time.

From July 2020 until the end of the year, women received most of this type of care at pre-pandemic levels, but not at higher levels that would regain lost care.

“This recovery to the initial levels, but not above them, means that a group of women lost these services throughout the year. The question is: what will it mean for them in the long run?” says Nora Becker, MD, Ph.D., lead study author and primary care physician at Michigan Medicine, UM’s academic medical center. “We still don’t know if they’ve reached 2021, but we’ll have to keep examining the data as it becomes available.”

Signs of disparity

The study also suggests that disparities in preventive care could have been exacerbated by the pandemic. Prior to the pandemic, women with lower incomes or less English-speaking skills and blacks or Latinos were already less likely to receive these services as recommended.

Although the anonymous data used in the study do not include information about the race, ethnicity, admissions, or English proficiency of individual patients, they do include information about the zip code. Becker used data from the U.S. Census Bureau’s American Community Survey to match zip codes with information on average income, the percentage of non-white residents, and the percentage of people who don’t speak English.

Overall, lower use of preventive care in 2020 was seen in women from zip codes who have lower average income levels, more non-white residents, or more incompetent English speakers.

“While these data do not allow us to know for sure that disparities worsened, it is worrying that many of these comparisons were advancing in the direction of worsening disparities that we already know existed,” Becker said.

“This study demonstrates the broad effects that the COVID-19 pandemic has had on other major health services,” said lead author John Z. Ayanian, MD, MPP, director of the IHPI. A long-time researcher on health disparities in preventive care, Ayanian is Professor of Medicine and Health Policy at Alice Hamilton University at UM Medical School, as well as Professor of Management and Health Policy at the School of Public Health and Professor of public policies. at the Gerald R. Ford School of Public Policy. He is also the editor of JAMA Health Forum but withdrew from the editorial decision process for the study.

Returning to the track

Becker, an assistant professor of internal medicine at the UM School of Medicine and a member of the IHPI, recommends that women contact their providers if they have skipped care in 2020 or if they have canceled appointments. but they have not been rescheduled by their suppliers during the spring of this year.

Similarly, it encourages providers to identify and reach out to higher-risk individuals who could benefit most from preventative care, for example, those who had already gone through a screening test when the pandemic hit or those who did. which others have or lifestyle factors that put them at risk for breast cancer, cervical cancer, STIs, or unplanned pregnancies.

The study points to a bigger issue whose responsibility is to remind women that they should have a mammogram, a Pap smear, an STI screening, or a new long-acting contraceptive implant to replace a that he has reached the end of his life.

Health insurers can send reminders, but clinicians are likely to review what types of services are needed after the patient has reached an appointment. If the patient does not attend an appointment, in person or via telemedicine, the physician will not necessarily realize that he or she must have won or must have won for a particular service.

Although a single late or lost mammogram or Pap smear may not have a significant impact on an individual woman’s life, as long as it is reprogrammed quickly, a missed relapse of birth control pills, an STI test, or an insertion of LARC, Becker noted.

Reducing social interaction during the pandemic, including reducing sexual activity among those who do not have sex, may offset some of the risk of sexually transmitted infection or unplanned pregnancy, he added. Recharges of birth control pills in pharmacies were lower throughout 2020, compared to 2019.

The study is based on data from 685,000 Michigan women between the ages of 18 and 74 who were enrolled in an employer-based plan or Medigap offered by Blue Cross Blue Shield of Michigan between January 2019 and January 2021 However, if a woman received a preventive service without using her insurance or was not covered by a BCBSM plan throughout the study period and received coverage for a service through a different plan, the data did not. would reflect.

Female cancer tests plummeted during the pandemic

More information:
Nora V. Becker et al, Use of women’s preventive health services during the COVID-19 pandemic, JAMA Health Forum (2021). DOI: 10.1001 / jamahealthforum.2021.1408

Citation: From birth control to mammograms, many women lost preventive care throughout 2020 (2021, July 16) recovered on July 17, 2021 at -07-birth-mammograms-women.html

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