Abstract
The COVID-19 pandemic has resulted in changes in healthcare use. This study aimed to identify factors associated with a patient’s decision to avoid and/or delay healthcare during the COVID-19 pandemic. We used data from a community-based survey in Portugal from July 2020 to August 2021, “COVID-19 Barometer: Social Opinion”, which included data regarding health services use, risk perception and confidence in health services. We framed our analysis under Andersen’s Behavioural Model of Health Services Use and utilised Poisson regression to identify healthcare avoidance associated factors. Healthcare avoidance was high (44%). Higher prevalence of healthcare avoidance was found among women; participants who reported lower confidence in the healthcare system response to COVID-19 and non-COVID-19; lost income during the pandemic; experienced negative emotions due to physical distancing measures; answered the questionnaire before middle June 2021; and perceived having worse health, the measures implemented by the Government as inadequate, the information conveyed as unclear and confusing, a higher risk of getting COVID-19, a higher risk of complications and a higher risk of getting infected in a health institution. It is crucial to reassure the population that health services are safe. Health services should plan their recovery since delays in healthcare delivery can lead to increased or worsening morbidity, yielding economic and societal costs.
Highlights
A higher prevalence of healthcare avoidance was found for individuals with lowand confidence in the9660 responses of health services and to COVID-19 and August 2021, individuals participated were included non-COVID-19 compared with individuals reporting higher trust in the health services in the analysis
(74.1%), individuals who lived in adequate perception (aPR): Lisbon and95%
Young adults and individuals who reported living in the North, Center or Azores had a lower prevalence of healthcare avoidance than working-age adults and individuals who reported living in Lisbon and Tagus Valley (Figure 2 and Table S1)
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. The World Health Organization (WHO) declared the novel coronavirus disease 2019. (COVID-19) a global pandemic on 11 March 2020 [1]. Restrictive measures were implemented to contain the pandemic, such as lockdowns, stay-at-home orders, movement restriction and closure of schools and non-essential businesses [2,3]. Several countries temporarily cancelled non-urgent medical activity to ensure the best care for COVID-19 cases, diverting attention from non-COVID-19 care and a reduction in care for these conditions [2–5]. The health services reorganisation might partially explain this reduction to respond to COVID-19, but the reduction might be explained by the patient’s avoidance or delay regarding attending healthcare due to the fear of getting COVID-19
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