No abstract

Th e COVID-19 pandemic has brought about a precipitous transformation in health care delivery in the nation's safety-net, primary care system of federally qualifi ed health centers (FQHCs). Th is study uses electronic health record data to quantify the extent of changes to visit volume in 36 FQHCs across 19 states as well as changes in quality metrics. We found a steep decline in in-person visits in March 2020 accompanied by a sharp increase in telehealth visits; however, combined volume remained 23% below pre-pandemic levels. Th e implications for public health are signifi cant, as preventive and chronic care deferral could lead to exacerbations of health disparities. Our examination of the impact on quality measures suggests that gaps in care are already emerging. Services that cannot be readily performed virtually are most aff ected. As FQHC visit numbers recover, concerted eff orts are needed to encourage access and re-engage at-risk groups that fell out of care.

There is a high frequency of unintended pregnancy and lack of contraceptive use among Hispanic women. These findings highlight the need for improved reproductive education and contraceptive counseling in this population.

For students testing positive in the Chicago school-based STI program, time to treatment is accelerated in locations with SBHCs.