{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T08:22:43Z","timestamp":1792830163432,"version":"4.5.0"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"funder":[{"name":"Advocate Charitable Foundation"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J GEN INTERN MED"],"DOI":"10.1007\/s11606-026-10389-4","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T20:42:35Z","timestamp":1779309755000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Demographic Differences in Long COVID Diagnosis Across Levels of Care: Implications for Clinical Practice"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8676-5546","authenticated-orcid":false,"given":"Anne","family":"Rivelli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Ording","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Sheehan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana L","family":"Hirschtick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"key":"10389_CR1","doi-asserted-by":"crossref","unstructured":"Ely EW, B.L., Fineberg HV. Long Covid Defined. N Engl J Med. 2024;391(18):1746\u20131753.","DOI":"10.1056\/NEJMsb2408466"},{"key":"10389_CR2","unstructured":"National Academies of Sciences, Engineering, and Medicine, Long-term health effects of COVID-19: disability and function following SARS-CoV-2 infection. 2024, The National Academies Press: Washington, DC."},{"key":"10389_CR3","doi-asserted-by":"crossref","unstructured":"Ford ND, A.A., Dalton AF, Singleton J, Perrine CG, Saydah S. Notes from the Field: Long COVID Prevalence Among Adults \u2014 United States, 2022. 2024, U.S. Centers for Disease Control and Prevention. p. 135\u2013136.","DOI":"10.15585\/mmwr.mm7306a4"},{"issue":"10453","key":"10389_CR4","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1016\/S0140-6736(24)01136-X","volume":"404","author":"T Greenhalgh","year":"2024","unstructured":"Greenhalgh T, et al. Long COVID: a clinical update. Lancet. 2024;404(10453):707-724.","journal-title":"Lancet."},{"issue":"12","key":"10389_CR5","doi-asserted-by":"publisher","first-page":"2959","DOI":"10.3390\/microorganisms11122959","volume":"11","author":"C Fern\u00e1ndez-de-las-Pe\u00f1as","year":"2023","unstructured":"Fern\u00e1ndez-de-las-Pe\u00f1as C, et al. Long COVID or Post-COVID-19 Condition: Past, Present and Future Research Directions. Microorganisms. 2023;11(12):2959.","journal-title":"Microorganisms."},{"issue":"4","key":"10389_CR6","doi-asserted-by":"publisher","first-page":"e102","DOI":"10.1016\/S1473-3099(21)00703-9","volume":"22","author":"JB Soriano","year":"2022","unstructured":"Soriano JB, et al. A clinical case definition of post-COVID-19 condition by a Delphi consensus. Lancet Infect Dis. 2022;22(4):e102-e107.","journal-title":"Lancet Infect Dis."},{"issue":"5","key":"10389_CR7","doi-asserted-by":"publisher","first-page":"1127","DOI":"10.1007\/s11606-022-07997-1","volume":"38","author":"D Khullar","year":"2023","unstructured":"Khullar D, et al. Racial\/Ethnic Disparities in Post-acute Sequelae of SARS-CoV-2 Infection in New York: an EHR-Based Cohort Study from the RECOVER Program. J Gen Int Med. 2023;38(5):1127-1136.","journal-title":"J Gen Int Med."},{"issue":"1","key":"10389_CR8","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1186\/s12916-023-02737-6","volume":"21","author":"ER Pfaff","year":"2023","unstructured":"Pfaff ER, et al. Coding long COVID: characterizing a new disease through an ICD-10 lens. BMC Med. 2023;21(1):58.","journal-title":"BMC Med."},{"issue":"8","key":"10389_CR9","doi-asserted-by":"publisher","first-page":"1350","DOI":"10.1093\/aje\/kwad095","volume":"192","author":"R Sedgley","year":"2023","unstructured":"Sedgley R, Winer-Jones J, Bonafede M. Long COVID Incidence in a Large US Ambulatory Electronic Health Record System. Am J Epidemiol. 2023;192(8):1350-1357.","journal-title":"Am J Epidemiol."},{"issue":"8","key":"10389_CR10","doi-asserted-by":"publisher","first-page":"1943","DOI":"10.1007\/s11606-021-07242-1","volume":"37","author":"F Desgranges","year":"2022","unstructured":"Desgranges F, et al. Post\u2011COVID\u201119 Syndrome in Outpatients: a Cohort Study. J Gen Int Med. 2022;37(8):1943-1952.","journal-title":"J Gen Int Med."},{"issue":"9","key":"10389_CR11","doi-asserted-by":"publisher","first-page":"1252","DOI":"10.7326\/M21-0878","volume":"174","author":"M Nehme","year":"2021","unstructured":"Nehme M, et al. Prevalence of Symptoms More Than Seven Months After Diagnosis of Symptomatic COVID-19 in an Outpatient Setting. Ann Intern Med. 2021;174(9):1252-1260.","journal-title":"Ann Intern Med."},{"issue":"10","key":"10389_CR12","doi-asserted-by":"publisher","first-page":"e2238804","DOI":"10.1001\/jamanetworkopen.2022.38804","volume":"5","author":"RH Perlis","year":"2022","unstructured":"Perlis RH, et al. Prevalence and Correlates of Long COVID Symptoms Among US Adults. JAMA Netw Open. 2022;5(10):e2238804-e2238804.","journal-title":"JAMA Netw Open."},{"key":"10389_CR13","doi-asserted-by":"publisher","first-page":"237437352210775","DOI":"10.1177\/23743735221077514","volume":"9","author":"L Calabrese","year":"2022","unstructured":"Calabrese L, Colloca L. Long COVID-19 and the Role of the Patient-Clinician Interaction in Symptom Management. J Patient Exp. 2022;9:23743735221077514. https:\/\/doi.org\/10.1177\/23743735221077514.","journal-title":"J Patient Exp."},{"issue":"11","key":"10389_CR14","doi-asserted-by":"publisher","first-page":"1620","DOI":"10.3390\/ijerph22111620","volume":"22","author":"SX Sui","year":"2025","unstructured":"Sui SX, Yu L. Patient and Professional Perspectives on Long COVID: A Systematic Literature Review and Meta-Synthesis. Int J Environ Res Public Health. 2025;22(11):1620. https:\/\/doi.org\/10.3390\/ijerph22111620.","journal-title":"Int J Environ Res Public Health."},{"issue":"3","key":"10389_CR15","doi-asserted-by":"publisher","first-page":"7","DOI":"10.7812\/TPP\/23.034","volume":"27","author":"EM Fratt","year":"2023","unstructured":"Fratt EM, Crosson FJ. Long COVID, Disability, and the Need for Timely Health Care Coverage. Perm J. 2023;27(3):7-9. https:\/\/doi.org\/10.7812\/TPP\/23.034.","journal-title":"Perm J."},{"key":"10389_CR16","unstructured":"Social Security Administration. Long COVID: A Guide for Health Professionals on Providing Medical Evidence for Social Security Disability Claims. 2023."},{"issue":"1","key":"10389_CR17","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1111\/j.2044-8287.2012.02077.x","volume":"18","author":"SE Scott","year":"2013","unstructured":"Scott SE, Walter FM, Webster A, Sutton S, Emery J. The model of pathways to treatment: conceptualization and integration with existing theory. Br J Health Psychol. 2013;18(1):45-65. https:\/\/doi.org\/10.1111\/j.2044-8287.2012.02077.x.","journal-title":"Br J Health Psychol."},{"issue":"8","key":"10389_CR18","doi-asserted-by":"publisher","first-page":"e008538","DOI":"10.1161\/CIRCHEARTFAILURE.121.008538","volume":"14","author":"AT Sandhu","year":"2021","unstructured":"Sandhu AT, Tisdale RL, Rodriguez F, Stafford RS, Maron DJ, Hernandez-Boussard T, Lewis E, Heidenreich PA. Disparity in the Setting of Incident Heart Failure Diagnosis. Circ Heart Fail. 2021;14(8):e008538. https:\/\/doi.org\/10.1161\/CIRCHEARTFAILURE.121.008538.","journal-title":"Circ Heart Fail."},{"issue":"2","key":"10389_CR19","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1093\/eurjhf\/hfq185","volume":"13","author":"JA Ezekowitz","year":"2011","unstructured":"Ezekowitz JA, Kaul P, Bakal JA, Quan H, McAlister FA. Trends in heart failure care: has the incident diagnosis of heart failure shifted from the hospital to the emergency department and outpatient clinics? Eur J Heart Fail. 2011;13(2):142-7. https:\/\/doi.org\/10.1093\/eurjhf\/hfq185.","journal-title":"Eur J Heart Fail."},{"issue":"3","key":"10389_CR20","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1016\/j.jchf.2022.11.013","volume":"11","author":"RL Tisdale","year":"2023","unstructured":"Tisdale RL, Fan J, Calma J, Cyr K, Podchiyska T, Stafford RS, Maron DJ, Hernandez-Boussard T, Ambrosy A, Heidenreich PA, Sandhu AT. Predictors of Incident Heart\u00a0Failure Diagnosis Setting: Insights From the Veterans Affairs Healthcare System. JACC Heart Fail. 2023;11(3):347-358. https:\/\/doi.org\/10.1016\/j.jchf.2022.11.013. Epub 2023 Feb 1. Erratum in: JACC Heart Fail. 2023 Jul;11(7):864. https:\/\/doi.org\/10.1016\/j.jchf.2023.05.020.","journal-title":"JACC Heart Fail."},{"key":"10389_CR21","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1186\/s12933-024-02211-4","volume":"23","author":"B Agvall","year":"2024","unstructured":"Agvall B, Jonasson JM, Galozy A, et al. Factors influencing hospitalization or emergency department visits and mortality in type 2 diabetes following the onset of new cardiovascular diagnoses in a population-based study. Cardiovasc Diabetol. 2024;23:124. https:\/\/doi.org\/10.1186\/s12933-024-02211-4.","journal-title":"Cardiovasc Diabetol."},{"issue":"7","key":"10389_CR22","doi-asserted-by":"publisher","first-page":"e2224359","DOI":"10.1001\/jamanetworkopen.2022.24359","volume":"5","author":"GN Ioannou","year":"2022","unstructured":"Ioannou GN, Baraff A, Fox A, et al. Rates and Factors Associated With Documentation of Diagnostic Codes for Long COVID in the National Veterans Affairs Health Care System. JAMA Netw Open. 2022;5(7):e2224359. https:\/\/doi.org\/10.1001\/jamanetworkopen.2022.24359.","journal-title":"JAMA Netw Open."},{"issue":"Suppl 9","key":"10389_CR23","doi-asserted-by":"publisher","first-page":"S18","DOI":"10.5694\/mja2.52458","volume":"221","author":"A Kamalakkannan","year":"2024","unstructured":"Kamalakkannan A, Prgomet M, Thomas J, Pearce C, McGuire P, Mackintosh F, Georgiou A. Factors associated with general practitioner-led diagnosis of long COVID: an observational study using electronic general practice data from Victoria and New South Wales, Australia. Med J Aust. 2024;221 Suppl 9:S18-S22. https:\/\/doi.org\/10.5694\/mja2.52458.","journal-title":"Australia. Med J Aust."},{"key":"10389_CR24","unstructured":"Centers for Disease Control and Prevention, New ICD-10-CM code for Post-COVID Conditions, following the 2019 Novel Coronavirus (COVID-19). 2021."},{"key":"10389_CR25","unstructured":"United States Census Bureau, 2018 American Community Survey Single-Year Estimates. 2019."},{"issue":"8","key":"10389_CR26","doi-asserted-by":"publisher","first-page":"e2225657","DOI":"10.1001\/jamanetworkopen.2022.25657","volume":"5","author":"SY Tartof","year":"2022","unstructured":"Tartof SY, et al. Health Care Utilization in the 6 Months Following SARS-CoV-2 Infection. JAMA Netw Open, 2022;5(8):e2225657.","journal-title":"JAMA Netw Open"},{"issue":"22","key":"10389_CR27","doi-asserted-by":"publisher","first-page":"1934","DOI":"10.1001\/jama.2023.8823","volume":"329","author":"T Thaweethai","year":"2023","unstructured":"Thaweethai T, et al. Development of a Definition of Postacute Sequelae of SARS-CoV-2 Infection. JAMA. 2023;329(22):1934-1946.","journal-title":"JAMA."},{"key":"10389_CR28","unstructured":"National Center for Health Statistics, Classification of Diseases, Functioning and Disability, ICD-10-CM, 2024, Centers for Disease Control and Prevention."},{"key":"10389_CR29","unstructured":"Institute of Medicine (US) Committee on the Future Health Care Workforce for Older Americans. Retooling for an Aging America: Building the Health Care Workforce. 2008, National Academies Press (US): Washington (DC)."},{"issue":"6","key":"10389_CR30","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1016\/j.jadohealth.2014.03.001","volume":"54","author":"JS Lau","year":"2014","unstructured":"Lau JS, et al. Young adults' health care utilization and expenditures prior to the Affordable Care Act. J Adolesc Health. 2014;54(6):663-71.","journal-title":"J Adolesc Health."},{"issue":"1","key":"10389_CR31","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1111\/hex.13370","volume":"25","author":"L Viktorsson","year":"2022","unstructured":"Viktorsson L, et al. Young adults' healthcare utilisation and healthcare needs: Perceptions and experiences of healthcare providers. Health Expect. 2022;25(1):245-253.","journal-title":"Health Expect."},{"issue":"7","key":"10389_CR32","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1136\/jech-2019-213435","volume":"74","author":"A H\u00f6hn","year":"2020","unstructured":"H\u00f6hn A, et al. Do men avoid seeking medical advice? A register-based analysis of gender-specific changes in primary healthcare use after first hospitalisation at ages 60+ in Denmark. J Epidemiol Commun Health. 2020;74(7):573-579.","journal-title":"J Epidemiol Commun Health."},{"issue":"1","key":"10389_CR33","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1186\/s12875-016-0440-0","volume":"17","author":"AE Thompson","year":"2016","unstructured":"Thompson AE, et al. The influence of gender and other patient characteristics on health care-seeking behaviour: a QUALICOPC study. BMC Fam Pract. 2016;17(1):38.","journal-title":"BMC Fam Pract."},{"key":"10389_CR34","doi-asserted-by":"publisher","first-page":"110589","DOI":"10.1016\/j.jpsychores.2021.110589","volume":"149","author":"AV Ballering","year":"2021","unstructured":"Ballering AV, et al. Sex differences in the trajectories to diagnosis of patients presenting with common somatic symptoms in primary care: an observational cohort study. J Psychosom Res. 2021;149:110589.","journal-title":"J Psychosom Res."},{"issue":"1","key":"10389_CR35","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1007\/s11606-021-06738-0","volume":"37","author":"L Parast","year":"2022","unstructured":"Parast L, et al. Racial\/Ethnic Differences in Emergency Department Utilization and Experience. J Gen Intern Med. 2022;37(1):49-56.","journal-title":"J Gen Intern Med."},{"issue":"1","key":"10389_CR36","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1186\/s12939-017-0670-3","volume":"16","author":"A Darin-Mattsson","year":"2017","unstructured":"Darin-Mattsson A, Fors S, K\u00e5reholt I. Different indicators of socioeconomic status and their relative importance as determinants of health in old age. Int J Equity Health. 2017;16(1):173.","journal-title":"Int J Equity Health."},{"key":"10389_CR37","doi-asserted-by":"publisher","unstructured":"Villasis NA, Santos JJ, Ettner SL, et al. Long COVID Disproportionately Reported by Disadvantaged Individuals: A National Survey of U.S. Working-Age Adults. J Gen Intern Med. 2025. https:\/\/doi.org\/10.1007\/s11606-025-09912-w.","DOI":"10.1007\/s11606-025-09912-w"},{"key":"10389_CR38","doi-asserted-by":"publisher","first-page":"7743","DOI":"10.1038\/s41598-024-58430-y","volume":"14","author":"A Eligulashvili","year":"2024","unstructured":"Eligulashvili A, Darrell M, Gordon M, et al. Patients with unmet social needs are at higher risks of developing severe long COVID-19 symptoms and neuropsychiatric sequela. Sci Rep. 2024;14:7743. https:\/\/doi.org\/10.1038\/s41598-024-58430-y.","journal-title":"Sci Rep."},{"key":"10389_CR39","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1016\/j.annepidem.2021.09.013","volume":"64","author":"N Mankowski","year":"2021","unstructured":"Mankowski N, et al. The effect of race, socioeconomic status, and comorbidity on patients afflicted with COVID 19: A Local Perspective, Annals of Epidemiology. 2021;64:83-87. https:\/\/doi.org\/10.1016\/j.annepidem.2021.09.013.","journal-title":"Annals of Epidemiology."},{"issue":"2","key":"10389_CR40","doi-asserted-by":"publisher","first-page":"e0298825","DOI":"10.1371\/journal.pone.0298825","volume":"19","author":"KC Ben-Umeh","year":"2024","unstructured":"Ben-Umeh KC, Kim J. Income disparities in COVID-19 vaccine and booster uptake in the United States: An analysis of cross-sectional data from the Medical Expenditure Panel Survey. PLoS ONE. 2024;19(2):e0298825. https:\/\/doi.org\/10.1371\/journal.pone.0298825.","journal-title":"PLoS ONE."},{"issue":"5","key":"10389_CR41","doi-asserted-by":"publisher","first-page":"E292","DOI":"10.1097\/PHH.0000000000002137","volume":"31","author":"ND Ford","year":"2025","unstructured":"Ford ND, Baca S, Dalton AF, Koumans EH, Raykin J, Patel PR, Saydah S. Use and Characteristics of Clinical Coding for Post-COVID Conditions in a Retrospective US Cohort. J Public Health Manag Pract. 2025;31(5):E292-E302. https:\/\/doi.org\/10.1097\/PHH.0000000000002137.","journal-title":"J Public Health Manag Pract."},{"issue":"3","key":"10389_CR42","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1080\/09687599.2022.2156848","volume":"38","author":"SA Devoto","year":"2023","unstructured":"Devoto, SA. Long COVID and chronic pain: overlapping racial inequalities. Disabil Soc. 2023;38(3):524-529.","journal-title":"Disabil Soc."}],"container-title":["Journal of General Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11606-026-10389-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11606-026-10389-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11606-026-10389-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T20:42:38Z","timestamp":1779309758000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11606-026-10389-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,20]]},"references-count":42,"alternative-id":["10389"],"URL":"https:\/\/doi.org\/10.1007\/s11606-026-10389-4","relation":{},"ISSN":["0884-8734","1525-1497"],"issn-type":[{"value":"0884-8734","type":"print"},{"value":"1525-1497","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,20]]},"assertion":[{"value":"1 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics Approval and Consent to Participate"}},{"value":"The authors declare that they do not have a conflict of interest.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}