Articles: pandemics.
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Early in the COVID-19 pandemic, primary care adopted telehealth rapidly to preserve access. Although policy flexibilities persist, but with in-person access restored, insight regarding long-term policy reform is needed for equitable access, especially for underserved, low income, and rural populations. ⋯ Findings demonstrate the importance of both phone and video visits in preserving primary care access early in the pandemic. Telehealth use declined in late COVID, but still accounted for ∼20% of primary care visits in the commercially insured setting and less than 10% of visits in the community care clinics. Differences in telehealth use were largely by setting, reflecting income/insurance status, indicating disparities needing to be addressed.
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In this issue of the Journal, several articles evaluate the strengths and weaknesses of telemedicine. Evidence demonstrates that telemedicine is not equally effective for all clinical situations. ⋯ Two studies report on the effects of the pandemic on the mental health of subpopulations. The impact of changing insurance status on chronic disease diagnoses, the implications of eliminating the X-waiver, and trends in early career family physician salaries are also studied.
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Implementation of Social Isolation Screening and an Integrated Community Resource Referral Platform.
Screening and referral programs for social isolation and loneliness in older patients increased during the COVID-19 pandemic in primary care settings to mitigate associated adverse health outcomes. This study explores community health centers' experiences implementing a social isolation and loneliness screening program involving a community resource referral platform integrated into the electronic health record to support referrals. ⋯ Screening older patients for social isolation could increase care team awareness of social risk; assistance related referral options should be considered carefully.
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COVID-19 has transformed the landscape of telemedicine utilization, shifting from predominantly in-person services to increased virtual encounters. Although telemedicine offers increased accessibility for medical care, many advocates voice concern about utilization and satisfaction with these services among individuals who experience intimate partner violence (IPV) given the unique practical, mental, and physical health challenges many face. ⋯ Clinicians using telemedicine should be aware of the multiple challenges faced by individuals experiencing IPV and take additional steps to ensure their needs are met in a safe way. These results have potentially important clinical and policy implications.