COVID testing and primary care changes among Community Health Centers

In an article published in the Journal of the American Medical Association, OHSU Family Medicine and OCHIN researchers show that Community Health Centers (CHCs) have provided vital testing services in the midst of the COVID-19 pandemic.

CHCs serve approximately 30 million people, including high proportions of patients susceptible to severe acute respiratory syndrome coronavirus. Many primary care practices lacked access to COVID-19 testing, PPE, and emergency financial resources in the first weeks of the pandemic. Despite this, CHCs reported thousands of COVID-19 tests, underscoring their important role in serving vulnerable populations. Many patients were seen for the first time at a CHC after the pandemic started, suggesting they are an access point in the midst of a crisis.

The study also tracked differences in testing and positive rates by race, ethnicity, preferred language, and insurance status. These differences suggest an ongoing need for targeted, language-concordant testing strategy.

Finally, the data shows a large-scale deferral of routine preventative services during the initial weeks of the pandemic. Although these temporary care deferrals have been necessary and unavoidable, the potential consequences are concerning: Reduction in preventive/chronic disease care may negatively affect long-term population health.

These findings will help inform future COVID research and may help inform steps that can be taken now to mitigate the effect of primary care deferral in the coming years.

The study was led by John Heintzman, M.D., M.P.H., Associate Professor of Family Medicine and OCHIN lead clinician scientist. Additional collaborators include Miguel Marino, Ph.D., and Natalie Huguet, Ph.D., from OHSU Family Medicine; Jean O'Malley, M.P.H., Jonathan V. Todd, Ph.D., M.S.P.H., and Rachel Gold, Ph.D., M.P.H., from OCHIN; and Kurt C. Strange, M.D., Ph.D., of Case Western Reserve University.