Associations between sociodemographic characteristics and medical care use during COVID-19: an Australian study

COVID-19 impacted how, and to what extent, health services were delivered. However, it is unclear to what extent individual and area-level characteristics impacted how people accessed health services and the ways in which health providers delivered such services.

We examined whether individual and area-level sociodemographic characteristics were associated with the delay and cancellation of medical care by patients and providers during COVID-19 in Australia.

Using the Household, Income and Labour Dynamics in Australia (HILDA) survey, logistic regression models examined associations between the delay and cancellation of medical care during COVID-19 and individual and area-level sociodemographic characteristics.

The analysis showed that providers delayed or cancelled appointments more than patients (10% vs 6.5% respectively), and delays and cancellations were significantly higher among females than males for both providers (odds ratio (OR) = 1.67, P = 0.00 < 0.05 95% confidence interval (CI): 1.50-1.85)) and patients (OR = 2.11, P = 0.00 < 0.05 (95% CI: 1.85-2.41)). Individuals with lower education were less likely to delay or cancel care (OR = 0.81, P = 0.01 < 0.05 (95% CI: 0.70-0.94)), and persons born in non-English-speaking countries were less likely to experience provider delays or cancellations than those born in Australia (OR = 0.69, P = 0.00 < 0.05 (95% CI: 0.58-0.83)). Older adults were more likely to have had care delayed or cancelled by both the providers and the patients themselves and people in more advantaged areas reported a lower probability of deferring treatment by providers.

Delays or avoidance of medical care can increase morbidity and mortality risk, with such findings useful in informing more targeted approaches to service delivery to ensure health equity.