![]() On the provider and delivery system side, there are just over 6,000 hospitals in the US the majority (approximately 80%) are privately owned, and of those, 70% are non-profits. In the US, patient out-of-pocket spending is approximately $1,125 per capita, or around 11% of total health expenditure. Nearly all physicians (90%) accept some type of private insurance, most (85%) accept Medicare, but only about 70% accept new patients insured by Medicaid, and acceptance of insurance type varies widely by physician specialty. About half (49%) of individuals obtain their insurance coverage privately via their employer, 14% from Medicare (primarily age-based, public, federal program), 20% from Medicaid (low-income, public, state-based program), 6% from the private individual market, 1% from the military/Veterans Administration, and 9% uninsured. The US has a predominantly private employer-based and individual insurance system, where enrollment is voluntary. Details of the national and state-level health and economic policy and technology responses are then discussed and related to the epidemiological spread of COVID-19 in the US.Īlthough the US spends more per capita on health care than any other nation, it has relatively poor health outcomes and health care coverage. We then describe the spread of the virus between January and August 2020. We first provide context for the pandemic and response by discussing US population health and the health care system. This paper presents an overview of the COVID-19 pandemic in the US. There has also been a strong tension between the desire to “re-open” the economy to mitigate financial hardship and efforts to contain the spread of the virus and reduce the health impacts. A primary issue in the US has been the poor coordination of testing efforts and inability to test at-scale to provide comprehensive national (or even state) surveillance. Much of the policy and technology reaction has been driven by individual state decisions, and even within states at the county level with little guidance from the national government. The United States (US) response to the COVID-19 pandemic has been defined by the division of power between the US state governments and the federal government. The COVID Tracking Project obtains testing and hospitalization data from state public health authorities. The JHU dashboard gathers data from the Center for Systems Science and Engineering at JHU, and multiple other sources, including US county and state health departments and data aggregating websites including the COVID Tracking Project. ![]() Specifically, the JHU dashboard includes US state and county-level data on the data elements listed in Table 4 Unlike the CDC, the JHU dashboard has collected testing and hospitalization data from local and state health departments from the beginning of the outbreak, making it a preferable data source to federal government sources such as the CDC or HHS. The Johns Hopkins University (JHU) Coronavirus Resource Center also tracks COVID-19 cases through a map-based dashboard and is updated multiple times per day. After a one-week hiatus, the data became available through HHS Protect, but as of August 9 continued to have issues with inconsistencies, delays, and missing data. ![]() In mid-July the Trump Administration required the CDC to stop reporting hospitalization and ICU data and mandated the Department of Health and Human Services (HHS) release these statistics via a new online platform, “HHS Protect”. ![]() The CDC provides a weekly report of provisional COVID-19 deaths by age and sex, and releases weekly updates of total provisional deaths by race/ethnicity. The national totals are based on state health department reports, and case rates are based on these reports and the 2018 US Census Bureau American Community Survey. ![]() The Centers for Disease Control and Prevention (CDC) is the leading federal public health institute in the US and releases daily updates on the number of total COVID-19 cases, new cases, total deaths, new deaths, and testing (the CDC began reporting testing data as of May 9, approximately 15 weeks after the first known US case on May 25 it was reported that the CDC had been conflating the results of antibody and viral tests). Associated Data Data Availability Statementĭata collection and reporting in the US is continually evolving. ![]()
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