Health Equity in COVID-19 Management
Issue
Racial and ethnic minority groups in the U.S. face health disadvantages, which can lead to worse illness, more deaths, and higher healthcare costs. During the COVID-19 pandemic and even several years later, these groups continue to be hit harder and be 19%-36% less likely to receive effective treatments, such as antiviral medications, compared to White patients.
Project Objective
Together with a team of national experts, AMGA and 3 health care organizations collaborated to complete a pragmatic multi-level (patient, provider, health system) needs assessment to identify opportunities for interventions to provide more equitable care for COVID-19. The 3 health care organizations then developed and implemented multi-level interventions to address management of COVID-19, specifically for Black and Hispanic patients. After the project, healthcare organizations can apply the processes used for developing health equity interventions to other topic areas of interest within their organization.
Results
109 provider and 467 patient surveys were completed across the 3 healthcare organizations as part of the pragmatic needs assessment. Key insights identified the following needs assessment:
Address side effect concerns from patients by sharing treatment benefits, especially for those with high-risk conditions
Address provider concerns on viral rebound by sharing FDA/CDC reports and current research
Encourage high-risk patients to seek care soon after initiation of COVID-19 symptoms or testing positive
Provider education on importance of timely treatment for high-risk patients, regardless of symptom severity
Standardization of treatment protocols to reduce provider bias
Understanding local context is a key component for identifying the most appropriate, targeted health equity interventions. For more details from the needs assessment data, view additional links below.
All healthcare organizations initially reported lower COVID-19 treatment prescription rates for Asian, Black, and Hispanic patients. Final results and manuscript coming soon!
Interventions
Initial thoughts for interventions from our kickoff meeting included:
- COVID-19 fatigue
- Sustainability of interventions
- Understand where patients are receiving treatment outside of ambulatory clinics (ED, specialists, urgent care)
- Take action on what data are already collected
- Do community-based organizations (CBOs) have anything to share
- Mixed method evaluation
- Establish long term partnerships
- Feedback loops
- Leverage existing infrastructure (e.g., mobile units)
- Start small ("going deep" within a narrow population)
- All departments
- CBOs (health and non-health focused)
- Churches
- Employee Resource Groups
- Federally Qualified Health Centers (FQHCs)
- Local Health Departments
- Other HCOs
Health equity interventions implemented by three AMGA members include:
More details coming soon!