Evidence map›Paper›PMID 42004397›Full record

ArticleJournal of public health research2026

Access to care during COVID-19: A qualitative study of healthcare system resilience in San Antonio, Texas.

Sandra Ovuegbe, Asha Collier, Danequa Forrest, Laura McKieran, Jack Tsai

Abstract read
In one paragraph

Article in Journal of public health research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Sandra OvuegbeBaylor College of Medicine, Houston, TX, USA.
Asha CollierTexas Department of State Health Services, Austin, TX, USA.
Danequa ForrestDepartment of Management, Policy, and Community Health, School of Public Health, San Antonio Campus, University of Texas Health Science Center at Houston, TX, USA.
Laura McKieranDepartment of Management, Policy, and Community Health, School of Public Health, San Antonio Campus, University of Texas Health Science Center at Houston, TX, USA.
Jack TsaiDepartment of Management, Policy, and Community Health, School of Public Health, San Antonio Campus, University of Texas Health Science Center at Houston, TX, USA.ORCID https://orcid.org/0000-0002-0329-648X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The COVID-19 pandemic challenged healthcare systems across the United States. It had distinct effects in rapidly growing cities like San Antonio, Texas. San Antonio, one of the fastest-expanding metropolitan areas, faces high rates of uninsured residents and a mix of urban and semi-rural healthcare landscapes. This makes it a valuable case for understanding health system responses to access challenges during public health crises. This qualitative study examined how healthcare system leaders, frontline providers, and policymakers in San Antonio navigated three major challenges during COVID-19: system-level disruptions in healthcare delivery, telehealth access, and health insurance coverage. Methods: From February to April 2023, data came from 2 focus groups ( Results: Participants identified three core challenges: First, disruptions in healthcare delivery due to workforce shortages, reduced preventive care access, and discharge delays. Second, barriers to telehealth access related to the digital divide and health literacy. Third, instability in health insurance coverage following the rollback of pandemic-era Medicaid protections. Participants also shared practice-based recommendations. These included standardized screening for social determinants of health (SDOH) with linked referrals to resources, culturally responsive food assistance programs, and hybrid care models that integrate telehealth with in-person care. Conclusion: This project shows that engaging local leadership and coordinating strategies can make systems more resilient. These actions improve healthcare access during public health crises and offer practical lessons for other urban healthcare systems.

Indexed as

COVID-19healthcare accesshealthcare systemshealth insurance instabilitytelehealthworkforce shortages

Identifiers

PMID42004397
PMCPMC13084032

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.