Researchers draw insights from COVID-19 to improve healthcare in times of crisis

Of the many challenges posed by the COVID-19 pandemic, healthcare disruptions have been among the most impactful. The pandemic was widespread, lasting more than two years and resulting in millions of hospitalizations and 1.2 million deaths in the United States alone. Meanwhile, routine medical services were affected by the pandemic; patients avoided healthcare visits for fear of contracting the virus; the home policy prevented patients from receiving routine care; and there was a limited range of services.

Recently under investigation published in NaturopathyJianxi Gao, Ph.D., associate professor of computer science at Rensselaer Polytechnic Institute, and his team measured the resilience and adaptability of our healthcare system to disruptions caused by COVID-19. Resilience is the ability of a system to absorb and recover from disruptions. Adaptability is the ability of a system to learn from previous disturbances when there are recurring disturbances.

Gao and his team analyzed millions of patient records using electronic health record data and examined 23 essential health care services across a wide range of health needs, including chronic disease care and maternal care.

“We found that our health care systems in the United States exhibit significant adaptability, but only moderate levels of resilience,” Gao said. “Our findings can inform the design of resilient and sustainable healthcare systems to prepare for future disruptions, whether caused by pandemics, climate change, conflict or something else.”

Gao and his team found that the healthcare system underwent two waves of disruptions. More than 90% of healthcare systems performed better during the second disruption, demonstrating adaptability. However, by the end of 2022, approximately 77% of healthcare services had not yet been fully restored to normal levels.

In states with high poverty rates and high unemployment, health care systems showed low resilience and adaptability, largely determined by the abundance of physicians. Furthermore, chronic disease care was more resilient and adaptive than maternal care, likely because long-term treatments are more flexible in delivery across settings, from home care to primary care and specialty care. Heart disease management services showed lower resilience and adaptability than conditions such as asthma, COPD, cancer and diabetes.

Gao and his team also found that the pandemic has severely affected Black and Hispanic health care, with greater disruptions and lower resilience. The disparities may be due to socioeconomic disparities that Black and Hispanic communities face in accessing health care services, especially during disruptions.

“The good news is that we can learn from this research and make changes to our healthcare systems for better outcomes,” Gao said. “We can strategically place physicians and focus resources on areas we have identified as vulnerable.”

“Dr. Gao’s framework for quantifying health care system resilience reveals valuable insights to ensure routine health care does not suffer during a future long-term crisis,” said Curt Breneman, Ph.D., dean of Rensselaer’s School of Science. “This research provides policymakers with the tools they need to adjust policies to ensure that all populations have equal access to health care, even under extraordinary circumstances.”

Gao was joined in the research by Lu Zhong, Ph.D., postdoctoral research associate at Rensselaer; Dimitri Lopez, graduate researcher at Rensselaer; and Sen Pei, Ph.D., assistant professor in the Department of Environmental Health Sciences at Columbia University’s Mailman School of Public Health.