Abstract Details

Title Associations Between Access to Healthcare and Race in Cardiac Arrest Survivors During the COVID-19 Pandemic

Topic Neuro Trauma, Critical Care, and Sports Neurology

Presentation(s) N1 - Neuroscience in the Clinic: Neurobiological Consequences of Racism on Health Outcomes (3:30 PM-3:45 PM)

Poster/Presentation
Number 002

Background

Cardiac arrest (CA) survivorship is complex and requires coordinated care to maintain medical, physical, and mental health. COVID-19 has disrupted this guideline-concordant CA care. We hypothesized that lack of access to medical care during the COVID-19 pandemic would be associated with increased emergency medicine visits and it will disproportionately affect minority groups.

Objective To examine the impact of the COVID-19 pandemic on access to healthcare in cardiac arrest (CA) survivors and the disparities in access across various race/ethnicities.

Design/Methods Between May 15th and July 31, 2020, CA survivors from a prospective cohort participated in a telephone-based assessment of the pandemic’s impact on their access to care for medical health (primary care appointments/medical procedures), physical health (rehabilitation services, home-health services), mental health (psychiatric or psychotherapy sessions). Primary endpoint was defined as a combined direct hospitalization or an emergency medicine visit.

Results Of 130 approached CA survivors, 105 participated (57% male; mean±SD age 58.5±17 years; 41% non-Hispanic White, 17% Black, 35% Latinx). Participants most frequently reported lack of access to care for medical aspects (55%), followed by physical (38%) and mental health (14%). Lack of access to medical care was significantly greater in blacks and Latinx patients compared to non-hispanic whites (73% vs 71% vs 35%, P=0.004). Patients reporting reduced access to medical care were six times more likely to seek emergency medical attention than those with continued access to their prior medical care even after adjuting for age, sex, race/ethnicity and COVID status (Odds Ratio 6.0; 95% CI: [1.5, 24]; p = 0.01).

Conclusions The disruption in medical care caused by the COVID-19 pandemic was associated with increased emergency visits among CA survivors and disproportionately affected minority communities, warranting a need for a reliable health-care delivery system during natural disasters.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
David J. Roh, MD (Columbia University Medical Center)	Dr. Roh has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Portola Pharmaceuticals.
Soojin Park, MD	Dr. Park has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurocritical Care. The institution of Dr. Park has received research support from National Institutes of Health.
Jan Claassen, MD, PhD (Columbia University College of Physicians & Surgeons)	Dr. Claassen has stock in iCE Neurosystems. The institution of Dr. Claassen has received research support from NINDS. The institution of Dr. Claassen has received research support from McDonnel Foundation. Dr. Claassen has received publishing royalties from a publication relating to health care. Dr. Claassen has received publishing royalties from a publication relating to health care.
	No disclosure on file
Sachin Agarwal, MD, MPH (Columbia University Med Center)	Dr. Agarwal has nothing to disclose.