Abstract
This paper combines SHARE Corona Survey and SHARE Wave 7 data for 25 European countries and Israel (N = 40,919) with institutional and epidemic-related country characteristics to investigate healthcare access for Europeans aged 50+ during the outbreak of COVID-19. We use a micro–macro approach to examine whether and to what extent barriers to accessing healthcare measured by reported unmet healthcare needs vary within and between countries. We consider various aspects of barriers and distinguish among: (1) respondents who forewent medical treatment because they were afraid of becoming infected with the Coronavirus; (2) respondents who had pre-scheduled medical appointments postponed by health providers due to the outbreak; and (3) respondents who tried to arrange a medical appointment but were denied one. Limited access to healthcare during the initial outbreak was more common for the occupationally active, women, the more educated and those living in urban areas. A bad economic situation, poor overall health and higher healthcare utilisation were robust predictors of unmet healthcare. People aged 50+ in countries of ‘Old’ Europe, countries with higher universal health coverage and stricter containment and closure policies were more likely to have medical services postponed. Policymakers should address the healthcare needs of older people with chronic health conditions and a poor socio-economic status who were made more vulnerable by this pandemic. In the aftermath of the health crisis, public health systems might experience a great revival in healthcare demand, a challenge that should be mitigated by careful planning and provision of healthcare services.
Highlights
Access to healthcare that can be captured by unmet healthcare need is considered as one of the most important achievements of health systems in developed countries (Allin et al 2010; OECD 2019)
This pandemic revealed that people with underlying health conditions were more likely to experience severe consequences of the infection (Clark et al 2020); for example, people diagnosed with diabetes, cardiovascular diseases, chronic respiratory conditions and cancer have been at higher risk for severe COVID-19 and death (WHO and UNDP 2020)
Given the fact that Europe is still far from having a common healthcare system, we focus on identifying whether the Bismarck and the Beveridge healthcare systems differ in respect to unmet health needs resulting from the epidemic control measures
Summary
Access to healthcare that can be captured by unmet healthcare need is considered as one of the most important achievements of health systems in developed countries (Allin et al 2010; OECD 2019). Increased burdens on health systems resulted in unprecedentedly high barriers to accessing healthcare for health conditions otherwise unrelated to COVID-19. It is believed that in the long-run, discontinued healthcare might potentially lead to serious health consequences for some individuals (Palmer et al 2020). This pandemic revealed that people with underlying health conditions were more likely to experience severe consequences of the infection (Clark et al 2020); for example, people diagnosed with diabetes, cardiovascular diseases, chronic respiratory conditions and cancer have been at higher risk for severe COVID-19 and death (WHO and UNDP 2020). Douglas et al (2020) pointed out that the health of older people is at particular risk due to the pandemic control measures because they are at the ‘...highest direct risk of severe COVID-19, they are more likely to live alone, less likely to use online communications and at risk of social isolation’ (p. 2)
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