Access to Care

The extent to which someone can gain access to the health care system, and the financial, social, and organizational factors that affect a person’s ability to get needed care in a timely way.

Characteristics, Outcomes, and Trends of Patients With COVID-19-Related Critical Illness at a Learning Health System in the United States

Jan. 19, 2021

George L. Anesi, Juliane Jablonski, Michael O. Harhay, Joshua H. Atkins, Jasmeet Bajaj, Cameron Baston, Patrick J. Brennan, Christina L. Candeloro, Lauren M. Catalano, Maurizio F. Cereda, John M. Chandler, Jason D. Christie, Tara Collins, Katherine R....

Abstract [from journal]

Background: The coronavirus disease 2019 (COVID-19) pandemic continues to surge in the United States and globally.

Objective: To describe the epidemiology of COVID-19-related critical illness, including trends in outcomes and care delivery.

Design: Single-health system, multihospital retrospective cohort study.

Setting: 5 hospitals within the University of Pennsylvania Health System.

Patients: Adults with COVID-19-related


Rationing, Racism and Justice: Advancing the Debate Around ‘Colourblind’ COVID-19 Ventilator Allocation

Nwamaka Eneanya, MD
Jan. 6, 2021

Harald Schmidt, Dorothy E. Roberts, Nwamaka D. Eneanya

Abstract [from journal]

Withholding or withdrawing life-saving ventilators can become necessary when resources are insufficient. In the USA, such rationing has unique social justice dimensions. Structural elements of dominant allocation frameworks simultaneously advantage white communities, and disadvantage Black communities—who already experience a disproportionate burden of COVID-19-related job losses, hospitalisations and mortality. Using the example of New Jersey’s Crisis Standard of Care policy, we describe how dominant rationing guidance


A Survivor-Derived Approach to Addressing Trafficking in the Pediatric ED

Jan. 1, 2021

Carmelle Wallace, Yvette Schein, Gina Carabelli, Heta Patel, Needhi Mehta, Nadia Dowshen, Nancy Kassam-Adams, Kenneth Ginsburg and Cynthia Mollen

Abstract [from journal]

Objectives: Our objective was to elicit the perspectives of survivors of child trafficking on addressing trafficking in the pediatric emergency department (ED) and, secondarily, to provide a survivor-derived framework to help pediatric emergency medicine (PEM) providers discuss trafficking with their patients.

Methods: We conducted in-depth, semistructured interviews with young adults who experienced trafficking as children and/or as adolescents. In the


Racial Disparities in Mental Health Outcomes Among Women With Early Pregnancy Loss

Jan. 1, 2021

Jade M. Shorter, Nathanael Koelper, Sarita Sonalkar, Maria A. Oquendo, Mary D. Sammel, Courtney A. Schreiber

Abstract [from journal]

Objective: To explore the relationship between race and depression symptoms among participants in an early pregnancy loss clinical trial.

Methods: We performed a planned secondary analysis of a randomized trial by comparing treatments for medical management of early pregnancy loss. We hypothesized that Black participants would have higher odds of risk for major depression (measured with the CES-D [Center for Epidemiological Studies-Depression] scale) 30 days after early pregnancy loss


Patient Characteristics Associated With Telemedicine Access for Primary and Specialty Ambulatory Care During the COVID-19 Pandemic

Lauren Eberly
Dec. 29, 2020

Lauren A. Eberly, Michael J. Kallan, Howard M. Julien, Norrisa Haynes, Sameed Ahmed M. Khatana, Ashwin S. Nathan, Christopher Snider, Neel P. Chokshi, Nwamaka D. Eneanya, Samuel U. Takvorian, Rebecca Anastos-Wallen, Krisda Chaiyachati...

Abstract [from journal]

Importance: The coronavirus disease 2019 (COVID-19) pandemic has required a shift in health care delivery platforms, necessitating a new reliance on telemedicine.

Objective: To evaluate whether inequities are present in telemedicine use and video visit use for telemedicine visits during the COVID-19 pandemic.

Design, Setting, and Participants: In this cohort study, a retrospective medical record review was conducted from March 16 to May 11, 2020, of all patients scheduled for...

Time To Address Disparities in Care by Appointment Time

Dec. 15, 2020

Allison H. Oakes, Mitesh S. Patel

Abstract [from journal]

Quality of care systematically decreases over the course of the day. Ensuring that patients seen later in the day receive the same care as patients seen first thing in the morning has broad clinical and economic implications for our health care system. In this article, we outline feasible near-term solutions to direct clinicians and patients toward consistently better primary care decisions, throughout the day. These insights could be adapted to address similar challenges in other health care settings.