Disruptions in Care and Support for Homebound Adults in Home-Based Primary Care in New York City During the COVID-19 Pandemic

Home Healthc Now. 2021 Jul-Aug;39(4):211-214. doi: 10.1097/NHH.0000000000000983.


Homebound older adults are a highly vulnerable population, yet little is known about their experiences with healthcare during the COVID-19 pandemic. We interviewed patients in home-based primary care (HBPC) in New York City by telephone in May and June of 2020. Interviews covered social supports, household activities, self-care, and medical care, and asked participants to compare current with prepandemic experiences. Among 70 participants, 37% were Black and 32% were Hispanic. Disruptions in the home included greater difficulty accessing paid caregivers (13.9%) and food (35.3%) than before the pandemic, and unaddressed household chores (laundry, 81.4%; food preparation, 11.4%). Black study participants were more likely than White and Hispanic participants to report disruptions in accessing medical care (13 [50.0%] vs. 3 [14.3%] vs. 6 [27.3%], respectively, p = 0.02), as well as food preparation and medication taking. Black patients in HBPC are at risk of disparities in healthcare and social support during the COVID-19 pandemic.

MeSH terms

  • Activities of Daily Living
  • Aged
  • Aged, 80 and over
  • COVID-19 / epidemiology*
  • Ethnicity / statistics & numerical data
  • Female
  • Food Insecurity
  • Health Services Accessibility / statistics & numerical data*
  • Home Care Services / organization & administration*
  • Homebound Persons*
  • Humans
  • Male
  • New York City / epidemiology
  • Pandemics
  • Primary Health Care / organization & administration*
  • SARS-CoV-2
  • Social Support