As the COVID-19 pandemic upends nearly every aspect of people’s lives, an important question looms large for millions of low-income and underserved patients. So, can they still see their own doctor?
Researchers from Case Western Reserve University and the nonprofit consulting firm OCHIN conducted a comprehensive national study of community-based health centers, the front-line primary care providers serving millions of America’s most vulnerable patients. The goal is to assess how consistently patients were able to see their primary care provider before, during, and after the COVID-19 pandemic.
This study Annual Report on Family Medicine, Researchers tracked an average of 354,000 patients per year at 186 community health centers from 2019 to 2023. Researchers found that these centers maintained consistently high levels of continuity of care throughout the five-year study.
For these patients, community health centers are not just convenient, they are the only option. The fact that these centers consistently maintained high quality care during one of the most turbulent periods in modern medical history means so much to the communities they serve.
Our findings reveal remarkable stories of resilience despite the unprecedented disruption of the COVID-19 pandemic, which has forced health systems across the country to cancel appointments, shift to telehealth, and operate under severe staffing constraints. ”
Kurt C. Stange, Distinguished University Professor, Case Western Reserve School of Medicine, Dorothy Jones Weatherhead Professor of Medicine
methodology
Researchers assessed continuity using the usual care provider (UPC) index, which measures how consistently patients were treated by their primary care provider, rather than by a different clinician each time. A score of 1.0 represents perfect continuity. This means that the patient saw the same health care provider each time.
The median UPC score was 1.0 each year, the highest possible level, even during the height of the pandemic. The average UPC has been consistently high, varying from a low of 0.822 in 2020 to a high of 0.831 in 2021.
However, the study also revealed some flaws.
“As we looked more closely at the 2023 data, we found that not all patients experienced the same level of treatment retention,” Stange said. “Significant disparities have emerged along racial, ethnic, economic, and demographic lines.”
Patients are less likely to see their primary care physician consistently.
- Patients with multiple chronic conditions faced even more difficulty seeing the same health care provider consistently.
- Hispanic patients faced decreased treatment continuity in both adults and children.
- Black and African American patients faced lower treatment continuity among adults.
- Low-income patients, or those living at or below 138% of the federal poverty level, were less likely to receive consistent care.
- Telehealth users were less likely to receive consistent care for both adults and children.
- Patients in larger practices faced lower persistence than patients in smaller practices.
“The differences identified in this study also occurred in community health centers focused on caring for historically underserved populations,” Stange said. “These disparities target identifiable gaps that are unique to systemic interventions that health systems, policy makers, and community health centers can address so that everyone can enjoy the benefits of receiving care from clinicians who know them.”
sauce:
Case Western Reserve University
Reference magazines:
Goose, R. others. (2026). Continuation of primary care in community health centers. Family medicine annual report. DOI: 10.1370/afm.250413. https://www.annfammed.org/content/24/2/124
