Work

Impact of the COVID-19 Pandemic on Ambulatory Pediatric Cardiology Care by Race, Ethnicity, and Socioeconomic Status

Year: 2025

Type: article

Abstract: To determine racial, ethnic, and socioeconomic status differences in access to ambulatory pediatric cardiology before and during the first year of the COVID-19 pandemic. Differences in completion of cardiology clinic visit of patients 0-18 years old scheduled March 13, 2019 - March 12, 2021 were examined by race, ethnicity, and Childhood Opportunity Index (COI). Visits were categorized as completed, delayed (completed within 6 months), or incomplete (no visit within 6 months). Comparisons were made between pre-pandemic and pandemic timepoints (March 2020, pandemic onset; April 2020, volume nadir; July 2020, volume recovery). Patients who were non-Hispanic Black, Hispanic, and living in very low COI areas had higher incomplete visit rates before and during the pandemic compared to non-Hispanic White patients and those living in very high COI areas. Hispanic patients had more incomplete visits during pandemic nadir and recovery compared to pre-pandemic ( p < 0.001, p = 0.02). Patients from very low COI areas had more incomplete visits during volume nadir ( p = 0.001). In multivariable analysis, patients from low and very low COI areas had more incomplete visits before the pandemic (aOR 1.65, aOR 1.62); differences resolved during the pandemic. The pandemic altered the disparity for the low COI group only ( p = 0.013). We saw statistically higher incomplete visit rates for Hispanic patients and those from lower COI areas preceding and during the pandemic. The pandemic did not exacerbate these disparities. Efforts to improve access to care are needed for at-risk populations. • Black & Hispanic patients had more incomplete visits preceding & during COVID-19 • Patients living in lower COI areas had higher rates of incomplete visits preceding & during COVID-19 • The pandemic did not exacerbate these disparities • Black patients & patients from lower COI areas had fewer telehealth visits early on • Institutional, community & legislative advocacy needed to improve access to care

Source: The Journal of Pediatrics Clinical Practice

DOI: 10.1016/j.jpedcp.2025.200199