Strategies to Promote Equity in the BWH COVID-19 Recovery Center

Principal Investigator: Elizabeth Gay

Authors: Ann-Marcia Tukpah MD, MPH1, MPH; Jhillika Patel2; Julie Sullivan3; Beret Amundson MD4; Miguel Linares MD4; Meera Sury4; Gerald Weinhouse MD1; Nancy Lange-Vaidya MD, MPH1; Daniela Lamas, MD1; Elizabeth Gay, MD1 1 Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital; 2 Department of Orthopaedic Surgery, Brigham and Women’s Hospital; 3 Lung Center A, Brigham and Women’s Hospital; 4 Department of Medicine, Brigham and Women’s Hospital
Lay Abstract

Patients recovering from COVID-19 may continue to experience ongoing symptoms such as shortness of breath, headaches, dizziness, fatigue, difficulty concentrating, chest pain, joint pains, alternations in sleep patterns, diminished smell, and taste. Brigham and Women’s Hospital (BWH) created the COVID Recovery Center (CRC) with multiple subspecialties available for patient care, in order to investigate patient characteristics, symptomology and post-COVID course. Currently, 465 patients have been seen and have been referred to pulmonary, neurology, ear/nose/throat, cardiology and sleep clinics among others. The disproportionate impact of COVID-19 on historically and currently socioeconomically disadvantaged communities of color is known. Therefore, through grant funding from the BWH Department of Medicine’s Health Equity Innovation Program, the CRC has began implementing strategies to address inequities in care. A series of strategies include identification of patients who could significantly benefit from assistance overcoming barriers such as transportation, and social work support services. We also focus on building community partnerships, currently in Mattapan, Roxbury and Jamaica Plain to enhance access to specialty care at BWH and to provide direct care within in the community. The CRC is committed to targeted interventions that help improve healthcare delivery for all, and serve communities that have experienced disproportionate burden of COVID-19.

Scientific Abstract

A subset of patients recovering from COVID-19 experience persistent symptoms. Brigham and Women’s Hospital’s multidisciplinary COVID Recovery Center (CRC) provides clinical care and investigates patient characteristics, symptomology and post-COVID course. Currently 465 patients have been seen and commonly report persistent dyspnea, headaches, dizziness, fatigue, and subspecialty referrals include pulmonary, neurology, ENT, and cardiology. Although COVID-19 disproportionately impacts historically and currently socioeconomically disadvantaged communities of color, CRC patients seen to date are not representative of this population. Over 70% of patients are white, ~90% are English-speaking, ~75% have managed care and only 20% were hospitalized. We recently began implementing strategies to address inequities in care through grant funding from the Department of Medicine’s Health Equity Innovation Program. We devised mechanisms to monitor and ensure provision of accessible, equitable care. This includes a stratification tool to identify most vulnerable patients that would highly benefit from resources such as transportation and social work support. We created indicators of accessible care delivery, for example, community engagement, based on number of patients seen in CRC through robust community partnership efforts in Mattapan, Roxbury and Jamaica Plain. The CRC offers an opportunity to expand community access to specialized care at BWH, using comprehensive analyses and methods.

Clinical Implications
The COVID-Recovery Center strategies for healthcare equity will ideally expand access to subspecialty care at Brigham and Women’s Hospital, which are likely to translate to benefits in health outcomes. We aim to provide care continuity for patients with ongoing need.

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