• David T Liss, Ta-Yun Yang, Magdalena Hamielec, Kathleen McAuliff, Laura K Rusie, and Nivedita Mohanty.
• Health Services Research Scientist, AllianceChicago, 225 W. Illinois Street, 5Th Floor, Chicago, IL, 60654, USA. dliss@alliancechicago.org.
• J Gen Intern Med. 2024 Jun 1; 39 (8): 137813851378-1385.

BackgroundCheckup visits (i.e., general health checks) can increase preventive service completion and lead to improved treatment of new chronic illnesses. After the onset of the COVID-19 pandemic, preventive service completion decreased in many groups that receive care in safety net settings.ObjectiveTo examine potential benefits associated with checkups in federally qualified health center (FQHC) patients.DesignRetrospective cohort study, from March 2018 to February 2022.PatientsAdults at seven FQHCs in Illinois.InterventionsCheckups during a two-year Baseline (i.e., pre-COVID-19) period and two-year COVID-19 period.Main MeasuresThe primary outcome was COVID-19 period checkup completion. Secondary outcomes were: mammography completion; new diagnoses of four common chronic illnesses (hypertension, diabetes, depression, or high cholesterol), and; initiation of chronic illness medications.Key ResultsAmong 106,114 included patients, race/ethnicity was most commonly Latino/Hispanic (42.1%) or non-Hispanic Black (30.2%). Most patients had Medicaid coverage (40.4%) or were uninsured (33.9%). While 21.0% of patients completed a checkup during Baseline, only 15.3% did so during the COVID-19 period. In multivariable regression analysis, private insurance (versus Medicaid) was positively associated with COVID-19 period checkup completion (adjusted relative risk [aRR], 1.15; 95% confidence interval, [CI], 1.10-1.19), while non-Hispanic Black race/ethnicity (versus Latino/Hispanic) was inversely associated with checkup completion (aRR, 0.89; 95% CI, 0.85-0.93). In secondary outcome analysis, COVID-19 period checkup completion was associated with 61% greater probability of mammography (aRR, 1.61; 95% CI, 1.52-1.71), and significantly higher probability of diagnosis, and treatment initiation, for all four chronic illnesses. In exploratory interaction analysis, checkup completion was more modestly associated with diagnosis and treatment of hypertension and high cholesterol in some younger age groups (versus age ≥ 65).ConclusionsIn this large FQHC cohort, checkup completion markedly decreased during the pandemic. Checkup completion was associated with preventive service completion, chronic illness detection, and initiation of chronic illness treatment.© 2023. The Author(s), under exclusive licence to Society of General Internal Medicine.

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