Dataset Information

Experience of the COVID-19 pandemic and support for safety-net expansion.

ABSTRACT: Did individuals' experiences with the harms of the COVID-19 pandemic influence their attitudes towards safety-net programs? To assess this question, we combine rich information about county-level impacts and individual-level perceptions of the early pandemic, repeated measurements of attitudes towards safety-net expansion, and pre-pandemic measurements of related political attitudes. Individuals facing higher county-level impact or greater perceived risks are more likely to support long-term expansions to unemployment insurance and government-provided healthcare when surveyed in June 2020. These differences persist across time, with experiences in the early months of the pandemic remaining strongly predictive of attitudes towards safety-net expansion in early 2021.

SUBMITTER: Rees-Jones A

PROVIDER: S-EPMC9263690 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

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Experience of the COVID-19 pandemic and support for safety-net expansion.

Rees-Jones Alex A D'Attoma John J Piolatto Amedeo A Salvadori Luca L

Journal of economic behavior & organization 20220708

Did individuals' experiences with the harms of the COVID-19 pandemic influence their attitudes towards safety-net programs? To assess this question, we combine rich information about county-level impacts and individual-level perceptions of the early pandemic, repeated measurements of attitudes towards safety-net expansion, and pre-pandemic measurements of related political attitudes. Individuals facing higher county-level impact or greater perceived risks are more likely to support long-term exp ...[more]

PMID: 35822063

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Project description:ImportanceFederally qualified health centers (FQHCs) provide care to 30 million patients in the US and have shown better outcomes and processes than other practice types. Little is known about how the COVID-19 pandemic contributed to FQHC capabilities compared with other practices.ObjectiveTo compare postpandemic operational characteristics and capabilities of FQHCs with non-FQHC safety net practices and non-FQHC, non-safety net practices.Design, setting, and participantsThis nationally representative survey conducted from June 2022 to February 2023 with an oversampling of safety net practices in the US included practice leaders working in stratified random selection of practices based on FQHC status, Area Deprivation Index category, and ownership type per a health care network dataset.ExposuresPractice type: FQHC vs non-FQHC safety net and non-FQHC practices.Main outcomes and measuresPrimary care capabilities, including 2 measures of access and 11 composite measures.ResultsA total of 1245 practices (221 FQHC and 1024 non-FQHC) responded of 3498 practices sampled. FQHCs were more likely to be independently owned and have received COVID-19 funding. FQHCs and non-FQHC safety net practices were more likely to be in rural areas. FQHCs significantly outperformed non-FQHCs on several capabilities even after controlling for practice size and ownership, including behavioral health provision (mean score, 0.53; 95% CI, 0.51-0.56), culturally informed services (mean score, 0.55; 95% CI, 0.53-0.58), screening for social needs (mean score, 0.43; 95% CI, 0.39-0.47), social needs referrals (mean score, 0.53; 95% CI, 0.48-0.57), social needs referral follow-up (mean score, 0.31; 95% CI, 0.27-0.36), and shared decision-making and motivational interviewing training (mean score, 0.53; 95% CI, 0.51-0.56). No differences were found in behavioral and substance use screening, care processes for patients with complex and high levels of need, use of patient-reported outcome measures, decision aid use, or after-hours access. Across all practices, most of the examined capabilities showed room for improvement.Conclusions and relevanceThe results of this survey study suggest that FQHCs outperformed non-FQHC practices on important care processes while serving a patient population with lower incomes who are medically underserved compared with patients in other practice types. Legislation to expand funding for the FQHC program should improve services for underserved populations and target current non-FQHC safety net practices to serve these populations. Increased support for these practices could improve primary care for rural populations.

Dataset Information

Experience of the COVID-19 pandemic and support for safety-net expansion.

Publications

Experience of the COVID-19 pandemic and support for safety-net expansion.

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