COVID-19 and Unmet Healthcare Needs of Older People: Did Inequity Arise in Europe?

Marta González-Touya,Alexandrina Stoyanova,Rosa M. Urbanos-Garrido

doi:10.3390/ijerph18179177

Abstract

Background: The disruption in healthcare provision due to the COVID-19 pandemic forced many non-urgent medical treatments and appointments to be postponed or denied, which is expected to have huge impact on non-acute health conditions, especially in vulnerable populations such as older people. Attention should be paid to equity issues related to unmet needs during the pandemic. Methods: We calculated concentration indices to identify income-related inequalities and horizontal inequity in unmet needs due to postponed and denied healthcare in people over 50 during COVID-19, using data from the Survey on Health, Ageing and Retirement in Europe (SHARE). Results: Very few countries show significant income-related inequalities in postponed, rescheduled or denied treatments and medical appointments, usually favouring the rich. Only Estonia, Italy and Romania show a significant horizontal inequity (HI) in postponed healthcare, which apparently favours the poor. Significant pro-rich inequity in denied healthcare is found in Italy, Poland and Greece. Conclusions: Although important income-related horizontal inequity in unmet needs of European older adults during the early waves of the COVID-19 pandemic is not evident for most countries, some of them have to carefully monitor barriers to healthcare access. Delays in diagnosis and treatments may ultimately translate into adverse health outcomes, reduced quality of life and, even, widen socio-economic health inequalities among older people.

Highlights

Equity in access to health care has been set as a central objective of most health care systems
Our paper contributes to the literature on equity in the utilization of health care and unmet needs among the older people across Europe during the COVID-19 pandemic
Despite the high levels of unmet needs and reorganization of care to enable the health system to face the challenges imposed by the pandemic, our findings indicate that inequity in postponed or denied treatments does not seem to be an issue of concern for most European countries, following previous evidence from the United

Summary

Introduction

Equity in access to health care has been set as a central objective of most health care systems. This implies that services should be accessible on the basis of need rather than on specific socio-economic circumstances (e.g., ability to pay or geographical location), race or sex. Universal health coverage characterises most European health systems, a basic feature to ensure equal access for equal need, many countries still face important access barriers. These may have intensified during the COVID-19 pandemic, when the priority of the health sector was infection prevention and control. Methods: We calculated concentration indices to identify income-related inequalities and horizontal inequity in unmet needs due to postponed and denied healthcare in people over 50 during

Objectives

Methods

Results

Discussion

Conclusion