Prevalence and determinants of healthcare avoidance during the COVID-19 pandemic: A population-based cross-sectional...

Area of Science:

• Public Health
• Epidemiology
• Healthcare Management

Background:

• The Coronavirus Disease 2019 (COVID-19) pandemic led to a significant decrease in healthcare utilization.
• Factors contributing to this decline include deferred elective care and patient healthcare avoidance.
• Understanding patient-driven healthcare avoidance and its determinants is crucial.

Purpose of the Study:

• To assess the prevalence of healthcare avoidance from a patient's perspective during the COVID-19 pandemic.
• To identify specific symptoms that were left unheeded by patients.
• To determine factors predisposing individuals to healthcare avoidance.

Main Methods:

• A cross-sectional survey was administered to 8,732 participants of the population-based Rotterdam Study.
• Healthcare avoidance and COVID-19-specific symptoms were assessed.
• Medical records were analyzed for verification, and logistic regression models identified determinants of avoidance.

Main Results:

• 20.2% of participants reported healthcare avoidance during the pandemic.
• A significant proportion (36.3%) of those avoiding care reported potentially urgent symptoms like chest pain and limb weakness.
• Older age, female sex, lower education, poor self-rated health, unemployment, smoking, and symptoms of depression and anxiety were associated with healthcare avoidance.

Conclusions:

• One in five individuals avoided healthcare during the COVID-19 pandemic, often for serious symptoms.
• Healthcare avoidance was strongly linked to female sex, perceived poor health, depression, and anxiety.
• Targeted public health messaging is needed to encourage vulnerable populations to seek timely medical care.