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COVID 19 Pandemic 1

The impact that the COVID-19 pandemic has had on

primary health care around the U.S. is considerable

Vanessa Garcia

St. Joseph’s College

HA 498:  Research in Health Administration

May 2021

Abstract

In today’s world, we are all suffering through this pandemic that has taken the lives of many people all around the world. Primary health care and all health care workers have had their losses whether it be a patient they were caring for or a loved one. This paper examines the essential part of management and how health care managers have been able to deal with day to day at work and home life. This research shows that during COVID-19, different changes had to be made to deal with employees and their new normal with this virus.

Table of Contents

Introduction................................................................................................................................... 1

Review of the Literature................................................................................................................ 3

Hypothesis.................................................................................................................................... 7

Research Design.......................................................................................................................... 8

Results/Findings.......................................................................................................................... 9

Limitations................................................................................................................................. 16

Conclusions and Recommendations......................................................................................... 18

References................................................................................................................................ 19

Appendix I............................................................................................................................. 21

Appendix II.............................................................................................................................. 22

Appendix III............................................................................................................................ 26

Introduction

The impact that the COVID-19 pandemic has had on primary health care around the world is considerable. The new coronavirus is highly destructive because it has managed to affect the health of people in a large number of ways. The pandemic has dramatically reduced access to primary health care in the majority of companies around the world including developed countries such as the United States and Australia (Halcomb 559). The poor access to health care services can lead to a decrease in the quality of life for millions of people throughout the world. In its turn, the decreased quality of life will impact economic as well as social development in a negative way leading to the spread of complex diseases. The COVID 19 pandemic has presented an international health crisis of a scope not seen in our lifetime. While much attention has been paid to health workers in critical care and acute areas, nurses working outside of hospitals are also significantly affected. This study sought to investigate the experience of nurses working in Australian primary health care during the COVID 19 pandemic. In particular, it sought to understand the implications on their employment status, role, and access to personal protective equipment. (Halcomb, 559). Health care administrators have been challenged throughout this entire COVID 19 pandemics. Hospital administrators have to deal with equipment shortages for patients and health care workers, staffing shortages, and also having to furlough staff and slashing benefits. For my research, I find that showing the age distribution of participants would be one of the ways to show my sample. There are various ways of displaying the "age" data. These include a simple table as illustrated in Table 5.3 and Figure 5.3. (Robson, 2014 p 117). I have age distribution of participants because my research study includes ages of Health Care Administrators and based on their answers it will

be interesting to see if the "age" group makes a difference in opinions in regards to health care administrators and how they have "coped" with the pandemic. Has work and home life affected them and their job duties? Has a certain age group lost more loved ones than others? 

Review of Literature

Covid 19; Hospital admission

Hospital admission during the COVID-19 pandemic was at its all-time high. The 2019–2020 pandemic Corona-virus Disease 2019 (COVID-19) has inundated hospital systems globally, as they prepare to accommodate the surge of patients requiring advanced levels of care. (Gupta, Federman,2020). Pandemic preparedness has not been this urgently and widely needed in the last several decades. According to epidemiological predictions, the peak of this pandemic has still not been reached, and hospitals everywhere need to ensure readiness to care for more patients than they usually do, and safety for health care workers who strive to save lives. We share our hospital-wide rapid preparedness and response to COVID-19 to help provide information to other health care systems globally. (Gupta, Federman, 2020). Within three months from the first diagnosed case of COVID-19 in the U.S.A. in late January 2020, the number of SARS-CoV2-infected individuals in the U.S.A. is close to a million, and the number of casualties has surpassed 45,000 [1]. Globally, SARS-CoV2 has infected millions, with an overall case fatality rate of >6.5% [1]. As rapid testing becomes more readily available in the next few weeks, it is expected that many more cases will be diagnosed, and many of them would need hospitalization for care. (Gupta & Federman, 2020).
COVID-19; Disruptive effects and improvements.

The COVID-19 pandemic has seen the health and medical research promoted as countries establish resilient health systems and rapidly responsive prevention, detection, and treatment methods. However, the pandemic will probably negatively affect the capacity and outcomes of the health and medical research sector itself. Research Australia is a national alliance of health and medical research stakeholders. In May 2020, all members on Research Australia's contact list were invited to participate in, and share with colleagues, a 10 min online survey. The questionnaire contained 52 questions about research and employment and perceptions of the effect of the pandemic on researchers' activities (Deakin Human Research Ethics Committee project number HEAG-H-71_2020). (Gupta, Federman, 2020). Data were analyzed with the use of descriptive statistics and logistic regression. 1212 members responded, with most of the responses from researchers in the university sector (79·4%), who are early in their career (41·7%), working full time (70·9%), and in permanent positions (38·1%; appendix). Overall, 79·6% of participants indicated that their research was affected by the pandemic, with a further 9·7% of participants indicating that it was likely to be affected in the future. (Peeters, 2002). Although COVID 19 has spread over 200 countries and has taken the lives of over 300,000 people, let's look at the facts. A human crisis like the COVID-19 pandemic has also offered some unique opportunities for the health care sector. It has allowed us to revisit the health care delivery. Rationalizing and optimizing the available resources during such a crisis are some of the most important lessons learned from this crisis. Although there has been a severe disruption in the health care delivery during this time globally, several positives have also come out of it viz., the effective use of telemedicine, the importance of personal hygiene, and the importance of infection control. (Brunier,2020). The virtual means of teaching, educating, and sharing knowledge have now become popular and acceptable. The research and publications have also seen a significant rise during these difficult times.

COVID 19; Physical and mental impacts

The physical and mental impacts COVID-19 had on essential workers is nothing short of what is called a disaster. A systematic literature search was conducted using two databases: PubMed and Google Scholar. We found 154 studies, and out of which 10 met our criteria. We collected information on the date of publication, first author’s country, the title of the article, study design, study population, intervention and outcome, and key findings, and divided all research articles into two domains: physical and mental health impact. (Shaukat, 2020). Our findings identified the following risk factors for COVID-19-related health impact: working in a high-risk department, diagnosed family member, inadequate hand hygiene, suboptimal hand hygiene before and after contact with patients, improper PPE use, close contact with patients (≥ 12 times/day), long daily contact hours (≥ 15 h), and unprotected exposure. (Shaukat, 2020). The most common symptoms identified amongst HCWs were fever (85%), cough (70%), and weakness (70%). Prolonged PPE usage led to cutaneous manifestations and skin damage (97%), with the nasal bridge (83%) most commonly affected site. HCWs experienced high levels of depression, anxiety, insomnia, and distress. Female HCWs and nurses were disproportionately affected. (Shaukat, 2020) The frontline health care workers are at risk of physical and mental consequences directly as the result of providing care to patients with COVID-19. Even though there are few intervention studies, early data suggest implementation strategies to reduce the chances of infections, shorter shift lengths, and mechanisms for mental health support could reduce the morbidity and mortality amongst HCWs. (Shaukat, 2020).

Hypothesis

H1. The COVID 19 has harmed primary healthcare in the United States.

Alt. COVID 19 has not had a positive impact on healthcare in the United States.

Null. A positive outcome on health care has no impact concerning COVID 19.

Research Design

This study will focus on fixed research by quantitative design by a survey. According to Robson; “Survey involves collecting data from groups of participants on a range of variables typically using questionnaires”, (Robson, 2014, p. 30). This study will research how COVID 19 has impacted primary health care around the U.S. This study will incorporate data from twenty participants that will be obtained through quantitative design by a survey. Collective data will be analyzed and shared. This study will use an explanation design in which questions will be derived from data by a survey. Quantitative research is based on collective data that can be quantified by numbers or can be converted into numbers, (Robson, 2014, p. 109). Quantitative designs can access a larger population by survey method and are used to verify if a hypothesis is correct. Quantitative designs can also change and manipulate data based on what is being studied. The hypothesis that will be proven during this study is; how Corona-virus has impacted health care around the U.S., and how health care administrators have been affected.

Results/Findings

Coronavirus is now the talk of the year and due to the pandemic, which has taken the lives of over 207,000, thousand people. Many people think that the Coronavirus was man-made and others think that it originated from Wuhan, China. Scientists first identified a human Coronavirus in 1965. It caused a common cold. Later that decade, researchers found a group of similar human and animal viruses and named them after their crown-like appearance. (WebMD,2020). This theory cannot be explained, and scientists and professionals are still trying to come up with a vaccine for this virus. People have failed to notice that this pandemic is not going anywhere anytime soon. If this continues, and it is believed that the Corona virus was man-made, we’ll never understand the larger question, which is why? By rethinking our approach and following the CDC guidelines we can potentially fix the issue and get rid of the Corona virus once and for all. I would like to find out more information on the following questions:

What are the health care issues created by the COVID-19 pandemic?

What is being done to address these issues?

What is the level of effectiveness of the current approaches to addressing the problem?

What are the consequences in case the issues are not properly addressed for both patients and health care organizations?

How can the COVID-19 pandemic transform the process of providing primary health care in the United States?

Interpretation of Findings

My theory is unsupported, as well as the written and discussed substance of the project report cannot be demonstrated either by the evidence presented (Spoorthy, et.al 2020).

Every one of the participants expressed their opinion upon this coronavirus, the problems and issues which arose with the impending disease outbreak, the problems brought to them through the disease outbreak, like the death of a loved, working remotely, Worked from home due to closings, children's learning being interrupted (Spoorthy, et.al 2020) due to school closures, the increasing living costs due to modern and irregular living norms, such as the wearing of masks, as well as an increase in taxation, resulting in wage reduction, from attached document showing the data of comparison between both the men and women sample of 10 people in diverse fields of study and varying levels of studies achieved (Spoorthy, et.al 2020).

It should be remembered that disease has harmful consequences for individuals or beings who are at greater risk of acquiring the virus, despite the government's stringent control and preventative methods imposed on the World Health Organization's recommendations to minimize transmission saving livelihood (Spoorthy, et.al 2020).

The thesis below will explain and where necessary explain what is justifiable about the global pandemic, Corona Virus: regarding World Health Organization and the Covid -19 response team (Spoorthy, et.al 2020).

health care issues created by the COVID-19 pandemic

The hypothesis will be addressed in the succeeding sections and include, interruption of health programs, disruption of management and cure of non-communicable diseases ( NCDs), social stigma, panic, alienation, death, and reduced income, as well as how the disease outbreak has produced health care problems(Boyle, et.al 2020).

First, as per a WHO study released on October 10, 2020, psychological health care systems are being disrupted in most countries around the globe even as demand for cognitive health treatment grows(Boyle, et.al 2020). COVID-19 has a detrimental effect on access to mental health services, as shown by global survey results from 130 nations, underscoring the immediate need for adequate funding.

According to the WHO, nations were investing less of their public health care budgets on mental well-being before the disease outbreak and were unable to meet the demands of their citizens(Boyle, et.al 2020). Countries would then raise funding to address the problems that have arisen as a result of the corona virus's spread.

Second, when the COVID-19 outbreak started, diagnosis and care programs for non-communicable diseases ( NCDs) were seriously disrupted, as shown in a WHO survey conducted by 155 countries over a three-week period in May, which indicated that the effect is global, with developing countries being the hardest hit. This is a serious situation because people who live with non-communicable diseases are at risk(Boyle, et.al2020).

According to Dr.Tedros, and Director-General of the World Health Organization(Boyle, et.al 2020). “Many people who need treatment for diseases like cancer, cardiovascular disease, and diabetes have not been receiving the health services and medicines they need since the COVID-19 pandemic began(Boyle, et.al 2020). Countries must find innovative ways to ensure that essential services for NCDs continue, even as they fight COVID-19.”

Death, loneliness, lack of income, and anxiety may all cause or exacerbate mental health problems(Boyle, et.al 2020). Many individuals may be experiencing a rise in alcohol and drug use, as well as anxiety and depression. COVID-19, on the other hand, can cause neurological and mental problems like delirium, anxiety, and stroke(Boyle, et.al 2020). People who have an emotional, neurological(Boyle, et.al 2020), or substance-abusing condition. More vulnerable to SARS-CoV-2 infection, they may stand a higher risk of severe outcomes and even death. 

PART ONE

PART TWO

In the first chart, the p-value is 0.053493, which is lower than the critical value of 0.05. hence the changes in independent variable are significant since it relates with the dependent variable. On the other hand, the second chart p-value is 0.366641, which is greater than 0.05. this shows that the variable is insignificant.

Limitations

This study's limitations are its flaws or demerits, resulting from unavailability of resources, small sample size, flawed methodology, among others. The respondents were limited to the educated and employed persons only. The small size could not give enough information to bring out exact findings.

Conclusions and Recommendations

The covid-19 pandemic has had a significantly negative impact on primary health care in the United States. Americans have been affected by the virus and have experienced deaths resulting from the virus. The mental health problem among the majority of the population has risen. The group that has been affected the most is the youth. The health care system has seen a shortage in personnel supply due to few qualified health practitioners. The health care administration has been directly exposed to the threat of contracting the virus. However, their salary has not experienced any increment due to the economic recess brought upon the country by the virus. Although the study had some flaws, it generated the general idea of how the pandemic has impacted the health care system and the health care administration in the U.S. To further research this topic a larger random sample size should be surveyed. Respondents should be from different hospitals in different locations.

References

Bhargava, H. (2020, April 15). Corona-virus History: How did Corona-virus start? Retrieved

October 01, 2020, from https://www.webmd.com/lung/coronavirus-history

Chen, Shu-ching, Lai, Yeur-Hur and Shiow-Luan Tsay. "Nursing Perspectives on the Impacts of Covid 19." The Journal of Nursing Research 28.3 (2020): 85.

David Blumenthal, M.D., M.P.P., Elizabeth J. Fowler, Ph.D., J.D., Melinda Abrams, M.S., and Sara R. Collins, Ph.D. "Covid-19-Implications for Health Care System." The New England Journal of Medicine 383 (2020): 1483-1488.

Donthu, Naveen and Anders Gustafsson. "Effects of COVID-19 on business and research." Journal of Business Research 17 (2020): 284-289.

Grégoire Mercier, Caroline Arquizan, Francois Roubille. "Understanding the effects of Covid 19 on Health care and systems." The Lancet Public Health 5.10 (2020): 524.

Gupta, Shaili and Daniel G. Federman. "Hospital preparedness for COVID-19 pandemic: experience from department of medicine at Veterans Affairs Connecticut health care System." Taylor & Francis Public Health Emergency Collection 132.6 (2020): 489-494.

Halcomb, Elizabeth, et al. "The Experiences of Primary health care Nurses During the

COVID‐19 Pandemic in Australia." Journal of Nursing Scholarship 52.5 (2020):

553-563.

Iyengar, Karthikeyan, et al. "Learning opportunities from COVID-19 and future effects on health care system." Elsevier Public Health Emergency Collection 14.5 (2020): 943-946.

Peeters, Anna, et al. "Covid-19's impact on Australia's health research workforce." The Lancet Regional Health 396.10249 (2020): 461.

Peiffer-Smadja, N., et al. "Challenges and issues about organizing a hospital to respond to the COVID-19 outbreak: experience from a French reference centre." Elsevier Public Health Emergency Collection 26.6 (2020): 669-672.

Robson, C. (2014). How to do a research project: a guide for undergraduate students. Chichester:

John Wiley & Sons.

Shaukat, Natasha, Daniyal Mansoor Ali and Junaid Razzak. "Physical and mental health impacts of COVID-19 on health care workers: a scoping review." International Journal of Emergency Medicine 13.40 (2020).

Tuttle, Katherine R. "Impact of the Covid 19 pandemic on clinical research." Nature Reviews Nephrology 16 (2020): 562-564.

Appendix 1

IMFORMED CONSENT:

The impact that Covid 19 pandemic has had on primary health care around the U.S.

3/7/2021

Thank you for participating in this research study about [The impact that Covid-19 has had on primary health care around the U.S. This research project is being conducted by Vanessa Garcia, Saint Joseph’s College, and is to satisfy the graduation requirements for a research capstone project. The objective of this research project is to find out how health care administrators have been able to cope with the recent pandemic and see what has been their best and worse experiences thus far. There are no known risks if you decide to participate in this research study, nor are there any costs for participating in the study. The information you provide will help me understand. The goal of my research is to obtain personal experiences from different department administrators. This survey is anonymous. If you choose to participate, do not write your name on the questionnaire. No one will be able to identify you. No one will know whether you participated in this study. The information collected for this research is only for this study and remains confidential.

Your participation in this study is voluntary. If you choose to participate, please click the link to take a survey. If you have any questions or concerns about completing the questionnaire or about being in this study, you may contact me, Vanessa Garcia, at [email protected]

St. Joseph’s College has reviewed my request to conduct this project. If you have any concerns about your rights in this study, please contact John Sardelis, Associate Chairperson Health Administration Professor, Doctor of Public. Health, M.A.A.A, A.S.A. at 631 687 1493 or Dr. Teresa Tannazzo, Ph.D., Director of Undergraduate Research, at [email protected] or 631.687.2693.

Thank you for your time and interest in furthering the cause of research

Appendix II

INCOME

What is your total HOUSEHOLD income before taxes?

Less than $25,000

$25,000 to $34,999

$35,000 to $49,999

$50,000 to $74,999

$75,000 to $99,999

$100,000 to $149,999

$150,000 to $199,999

$200,000 or more

RACE / ETHNICITY (ASK BOTH)

(ask this question and next question together): Are you of Hispanic, Latino, or Spanish origin?

No

Yes

With which racial group do you self-identify? For purposes of this question, persons of Spanish/Hispanic/Latino origin may be of any race.

Black or African American

American Indian and Alaska Native

Asian

Native Hawaiian and Other Pacific Islander

Caucasian

Bi-racial

Other race / do not wish to answer

AGE

Which is your age group?

18 to 24 years

25 to 34 years

35 to 44 years

45 to 54 years

55 to 64 years

65 to 74 years

75 and up

EDUCATIONAL ATTAINMENT

What is the highest degree or level of education you have completed?

Less than high school

High school graduate (includes equivalency)

Vocational Certification

Some college, no degree

Associate degree

Bachelor's degree

Ph.D.

Other professional degrees, e.g., JD, MD, DDS

GENDER

What is your gender?

Female

Male

Non-binary

Prefer not to answer

EMPLOYMENT STATUS

Which of these descriptions best describes your current employment status?

Employed full time

Employed part-time

Unemployed and currently looking for work

Unemployed and not currently looking for work

Student

Retired

Homemaker

Self-employed

Unable to work

What are the health care administrative issues created by the COVID-19 pandemic?

Short-staffed

Employees being infected with the virus

Turnaround times

All of the above

What is being done to address these issues?

Hiring more employees

More overtime for current employees

What is the level of effectiveness of the current approaches to addressing the problem?

What has been the toughest to manage during the COVID 19 pandemic?

Work

Homelife

Virtual learning with children (only applies to you if you you’re a parent)

Employees

Wearing a mask

Have you lost a loved one due to the coronavirus?

Yes

No

And if so, has that changed your attitude on trying to be the best administrator to your employees?

Yes

No

Don’t wish to answer

Appendix 3