The COVID‐19 pandemic impact on independent and provider‐based rural health clinics’ operations and cancer prevention and screening provision in the United States

The COVID-19 pandemic has disrupted cancer care, but it is unknown how the pandemic has affected care in Medicare-certified rural health clinics (RHCs) where cancer prevention and screening services are critical for their communities. This study examined how the provision of these cancer services ch...

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Bibliographic Details
Published in:The Journal of Rural Health Vol. 39; no. 4; pp. 765 - 771
Main Authors: Zahnd, Whitney E., Silverman, Allie F., Self, Stella, Hung, Peiyin, Natafgi, Nabil, Adams, Swann Arp, Merrell, Melinda A., Owens, Otis L., Crouch, Elizabeth L., Eberth, Jan M.
Format: Journal Article
Language:English
Published: England Wiley 01.09.2023
Wiley Subscription Services, Inc
Subjects:
Aged
Breast cancer
breasts
Cancer
Cervical cancer
Clinics
Colorectal cancer
Colorectal carcinoma
COVID-19
COVID-19 infection
Cross-Sectional Studies
Disease prevention
Early Detection of Cancer
Health services
Humans
Lung cancer
lungs
Medical screening
Medicare
Neoplasms
pandemic
Pandemics
Patients
Personal finance
Prevention
Prevention programs
Protective equipment
Rank tests
Rural Health
Safety equipment
Services
Stress
Tests
United States
cancer prevention
COVID-19 pandemic
rural health clinics
ISSN:0890-765X, 1748-0361, 1748-0361
Online Access:Get full text
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Summary:The COVID-19 pandemic has disrupted cancer care, but it is unknown how the pandemic has affected care in Medicare-certified rural health clinics (RHCs) where cancer prevention and screening services are critical for their communities. This study examined how the provision of these cancer services changed pre- and peri-pandemic overall and by RHC type (independent and provider-based). We administered a cross-sectional survey to a stratified random sample of RHCs to assess clinic characteristics, pandemic stressors, and the provision of cancer prevention and control services among RHCs pre- and peri-pandemic. We used McNemar's test and Wilcoxon signed rank tests to assess differences in the provision of cancer prevention and screening services pre- and peri-pandemic by RHC type. Of the 153 responding RHCs (response rate of 8%), 93 (60.8%) were provider-based and 60 (39.2%) were independent. Both RHC types were similar in their experience of pandemic stressors, though a higher proportion of independent RHCs reported financial concerns and challenges obtaining personal protective equipment. Both types of RHCs provided fewer cancer prevention and screening services peri-pandemic-5.8 to 4.2 for provider-based and 5.3 to 3.5 for independent (P<.05 for both). Across lung, cervical, breast, and colorectal cancer-related services, the proportion of both RHC groups providing services dropped peri-pandemic. The pandemic's impact on independent and provider-based RHCs and their patients was considerable. Going forward, greater resources should be targeted to RHCs-particularly independent RHCs-to ensure their ability to initiate and sustain evidence-based prevention and screening services.
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ISSN:0890-765X
1748-0361
1748-0361
DOI:10.1111/jrh.12753