Mental and Physical Health Outcomes Reported at Follow-up as a Function of Delaying Medical and Behavioral Health Care
Outcome by Delay Category | Unadjusted | 95% CI | P | Adjusted | 95% CI | P |
---|---|---|---|---|---|---|
Delay of Medical Care | ||||||
*Mental Health Summary Score | ||||||
No Delay in Care (ref) | — | — | — | — | — | — |
Delayed Care Once | −0.76 | −1.82, 0.17 | 0.16 | −0.61 | −1.29, 0.07 | 0.08 |
Delayed Care >1 | −4.20 | −5.10, −3.24 | <0.001 | −1.27 | −1.87, −0.66 | <0.001 |
*Physical Health Summary Score | ||||||
No Delay in Care (ref) | — | — | — | — | — | — |
Delayed Care Once | 0.77 | −0.40, 1.95 | 0.20 | −0.56 | −1.28, 0.17 | 0.13 |
Delayed Care >1 | −2.47 | −3.52, −1.44 | <0.001 | −1.26 | −1.91, −0.61 | <0.001 |
PHQ-9 | ||||||
No Delay in Care (ref) | — | — | — | — | — | — |
Delayed Care Once | 0.41 | −0.27, 1.10 | 0.24 | 0.19 | −0.30, 0.69 | 0.48 |
Delayed Care >1 | 2.41 | 1.81, 3.02 | <0.001 | 0.84 | 0.39, 1.28 | <0.001 |
GAD-7 | ||||||
No Delay in Care (ref) | — | — | — | — | — | — |
Delayed Care Once | 0.40 | −0.21, 1.01 | 0.20 | 0.05 | −0.40, 0.49 | 0.84 |
Delayed Care >1 | 2.02 | 1.48, 2.56 | <0.001 | 0.71 | 0.32, 1.10 | <0.001 |
*METs | ||||||
No Delay in Care (ref) | — | — | — | — | — | — |
Delayed Care Once | 0.37 | 0.12, 0.62 | 0.004 | −0.12 | −0.28, 0.41 | 0.14 |
Delayed Care >1 | −0.06 | −0.29, 0.04 | 0.61 | −0.07 | −0.22, 0.08 | 0.36 |
Delay of Behavioral Health Care | ||||||
*Mental Health Summary Score | ||||||
No Delay in Care (ref) | — | — | — | — | — | — |
Delayed Care Once | −2.42 | −4.53, −0.30 | 0.03 | −0.65 | −2.01, 0.80 | 0.38 |
Delayed Care >1 | −5.56 | −7.23, −3.88 | <0.001 | −1.70 | −2.83, −0.57 | 0.003 |
*Physical Health Summary Score | ||||||
No Delay in Care (ref) | — | — | — | — | — | — |
Delayed Care Once | 0.63 | −1.68, 2.94 | 0.60 | 0.49 | −1.00, 2.00 | 0.52 |
Delayed Care >1 | −3.94 | −5.77, −2.11 | <0.001 | −1.17 | −2.34, −0.01 | 0.05 |
PHQ-9 | ||||||
No Delay in Care (ref) | — | — | — | — | — | — |
Delayed Care Once | 1.73 | 0.09, 3.36 | 0.04 | 0.79 | −0.45, 2.04 | 0.21 |
Delayed Care >1 | 3.68 | 2.38, 4.98 | <0.001 | 1.17 | 0.20, 2.14 | 0.02 |
GAD-7 | ||||||
No Delay in Care (ref) | — | — | — | — | — | — |
Delayed Care Once | 1.40 | −0.06, 2.85 | 0.06 | 0.29 | −0.97, 1.37 | 0.60 |
Delayed Care >1 | 3.12 | 1.96, 4.28 | <0.001 | 1.34 | 0.49, 2.20 | 0.002 |
*METs | ||||||
No Delay in Care (ref) | — | — | — | — | — | — |
Delayed Care Once | 0.26 | −0.25, 0.76 | 0.32 | 0.04 | −0.32, 0.40 | 0.83 |
Delayed Care >1 | −0.52 | −0.91, −0.12 | 0.10 | −0.26 | −0.53, 0.02 | 0.07 |
Abbreviations: PHQ, patient health questionnaire; GAD, generalized anxiety disorder; MET, metabolic equivalents.
↵* Higher scores indicate better health.
Adjusted models control for baseline outcome measure, age, sex, race, ethnicity, marital status, income, employment, count of chronic conditions, neighborhood social deprivation, food, housing, and financial social determinants of health, and time into the COVID-19 pandemic.