Differential Impact of the COVID-19 Pandemic on Health Care Utilization Disruption for Community-Dwelling Individuals With and Without Acquired Brain Injury

Grace J. Kim, PhD, OTR/L; Hayejin Kim, MA, OTR/L; Jason Fletcher, PhD; Gerald T. Voelbel, PhD; Yael Goverover, PhD, OTR/L; Peii Chen, PhD; Michael W. O'Dell, MD; Helen M. Genova, PhD

Archives of Rehabilitation Research and Clinical Translation (Mar 2022)

Differential Impact of the COVID-19 Pandemic on Health Care Utilization Disruption for Community-Dwelling Individuals With and Without Acquired Brain Injury

Grace J. Kim, PhD, OTR/L,
Hayejin Kim, MA, OTR/L,
Jason Fletcher, PhD,
Gerald T. Voelbel, PhD,
Yael Goverover, PhD, OTR/L,
Peii Chen, PhD,
Michael W. O'Dell, MD,
Helen M. Genova, PhD

Affiliations

Grace J. Kim, PhD, OTR/L: Department of Occupational Therapy, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York; Department of Rehabilitation Medicine, NYU Langone Health, New York, New York; Corresponding author Grace J. Kim, PhD, OTR/L, New York University, Department of Occupational Therapy, 82 Washington Sq East, Pless Hall, 6th Floor, New York, NY 10003.
Hayejin Kim, MA, OTR/L: Department of Occupational Therapy, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York
Jason Fletcher, PhD: Rory Meyers College of Nursing, New York University, New York, New York
Gerald T. Voelbel, PhD: Department of Occupational Therapy, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York; Department of Rehabilitation Medicine, NYU Langone Health, New York, New York
Yael Goverover, PhD, OTR/L: Department of Occupational Therapy, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York
Peii Chen, PhD: Kessler Foundation, West Orange and East Hanover, New Jersey; Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers University, Newark, New Jersey
Michael W. O'Dell, MD: Department of Rehabilitation Medicine, Weill Cornell Medicine, New York, New York
Helen M. Genova, PhD: Kessler Foundation, West Orange and East Hanover, New Jersey; Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers University, Newark, New Jersey

Journal volume & issue: Vol. 4, no. 1
p. 100176

Abstract

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Objective: To delineate health care disruption for individuals with acquired brain injury (ABI) during the peak of the pandemic and to understand the impact of health care disruption on health-related quality of life (HRQoL). Design: Cross-sectional survey. Setting: General community. Participants: Volunteer sample of adults with traumatic brain injury (TBI; n=33), adults with stroke (n=66), and adults without TBI or stroke (n=108) with access to the internet and personal technology (N=207). Interventions: Not applicable. Main Outcome Measures: Not applicable. Results: Participants with TBI and stroke reported high rates of disruption in care specific to their diagnosis (53%-54.5%), while participants across all groups reported disruption for major medical care (range, 68.2%-80%), general health care (range, 60.3%-72.4%), and mental health care (range, 31.8%-83.3%). During the pandemic, participants with TBI and stroke used telehealth for care specific to their diagnosis (40.9%-42.4%), whereas all participants used telehealth for major medical care (range, 50%-86.7%), general health care (range, 31.2%-53.3%), and mental health care (range, 53.8%-72.7%). Disruption in TBI or stroke care and type of ABI explained 27.1% of the variance in HRQoL scores (F2,95=16.82, P<.001, R2=0.262), and disruption in mental health care explained 14.8% of the variance (F1,51=8.86, P=.004, R2=0.148). Conclusions: Individuals with and without ABI experienced pronounced disruption in health care utilization overall. However, individuals who experienced a disruption in care specific to TBI or mental health care were most vulnerable to decreased HRQoL. Telehealth was a viable alternative to in-person visits for individuals with and without ABI, but limitations included difficulty with technology, difficulty with comprehensive examination, and decreased rapport with providers.

Published in Archives of Rehabilitation Research and Clinical Translation

ISSN: 2590-1095 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Medicine (General)
Website: https://www.journals.elsevier.com/archives-of-rehabilitation-research-and-clinical-translation

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