Factors associated with self-reported healthcare utilization avoidance during the COVID-19 pandemic in Ireland:...

Implementation of public health measures during the first wave of the coronavirus disease (COVID-19) pandemic, including travel restrictions and physical distancing, may have impacted population behaviour in seeking medical care. Identifying factors associated with healthcare avoidance is important, especially for vulnerable groups.

A national cross-sectional telephone survey addressing the impact of public health restrictions on physical, mental and social wellbeing, was conducted during the first period of easing of COVID-19 restrictions in May and June 2020. Secondary data analysis of the dataset was carried out to examine the factors associated with self-reported deliberate/conscious avoidance of General Practitioner (G.P.) and hospital-based care. Poisson regression analyses were conducted to estimate risk ratios with robust variance estimation of the association between selected demographic and self-reported health factors and the risk of avoiding G.P. and hospital-based healthcare.

Of the 969 participants, 152 (15.7%) deliberately avoided contacting their G.P. about non COVID-19 related concerns while 81 (8.4%) reported avoiding hospitals. In multivariate analyses, three groups, women (Rate Ratio(RR): 1.77, 95% Confidence Interval (CI): 1.30 - 2.43), individuals who reported experiencing an adverse life event within the previous 3 months (RR: 1.70, 95% CI: 1.27 - 2.28), and those with self-reported poor health status (trend p < 0.001) were more likely to report that they avoided contact with their G.P. Individuals at a higher risk of avoiding hospital-based care were older (trend with age, p = 0.063), those who tended to agree they were "likely to catch COVID-19" (trend p = 0.052), and those with self-reported poor health status (trend p <0.001).

These findings highlight the importance of public health awareness and education regarding accessing healthcare during a pandemic and should be considered in future pandemic preparedness.