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COVID-19 导致 27 个欧洲国家的老年人失业和医疗保健利用率降低。

Job loss and lower healthcare utilisation due to COVID-19 among older adults across 27 European countries.

机构信息

Research Centre for Toxic Compounds in the Environment (RECETOX), Faculty of Science, Masaryk University, Brno, Czech Republic

Research Centre for Toxic Compounds in the Environment (RECETOX), Faculty of Science, Masaryk University, Brno, Czech Republic.

出版信息

J Epidemiol Community Health. 2021 Nov;75(11):1078-1083. doi: 10.1136/jech-2021-216715. Epub 2021 May 12.

Abstract

BACKGROUND

Older adults are at greater risk for becoming severely ill from COVID-19; however, the impact of the pandemic on their economic activity and non-COVID-19-related healthcare utilisation is not well understood. The aim of this study was to examine the prevalence and predictors of COVID-19-related unemployment and healthcare utilisation in a sample of older adults across 27 European countries.

METHODS

We used data from the Survey of Health, Ageing and Retirement in Europe COVID-19 Survey, collected between June and August 2020. Participants (n=52 061) reported whether they lost a job, forwent medical treatment and whether their appointment was postponed due to COVID-19. Three-level models were estimated for each outcome to test the effects of individual, household and country-level characteristics.

RESULTS

The mean prevalence of reported job loss, and forgone and postponed medical care was 19%, 12% and 26%, respectively. Job loss was associated with female sex, lower education and household income, and older age in women. For example, the OR of job loss, comparing primary versus tertiary (college) education, was 1.89 (95% CI 1.59 to 2.26). Forgone and postponed medical care was associated with older age in men, female sex and higher education. At the country level, postponed medical care was associated with more stringent governmental anti-COVID measures.

CONCLUSION

Job loss and lower healthcare utilisation for non-COVID-19-related reasons were common among older adults and were associated with several sociodemographic characteristics. Job loss appeared to disproportionally affect already economically vulnerable individuals, raising concerns about the exacerbation of social inequalities.

摘要

背景

老年人感染 COVID-19 后病情加重的风险更高;然而,大流行对他们经济活动和非 COVID-19 相关医疗保健利用的影响尚不清楚。本研究的目的是调查 27 个欧洲国家的老年人群体中 COVID-19 相关失业和医疗保健利用的流行率和预测因素。

方法

我们使用了欧洲健康、老龄化和退休调查 COVID-19 调查的数据,这些数据是在 2020 年 6 月至 8 月之间收集的。参与者(n=52061)报告了他们是否因 COVID-19 失业、放弃治疗以及他们的预约是否因 COVID-19 而推迟。为了测试个人、家庭和国家层面特征的影响,我们对每个结果都进行了三水平模型估计。

结果

报告的失业、放弃和推迟医疗的平均流行率分别为 19%、12%和 26%。失业与女性、较低的教育和家庭收入以及女性年龄较大有关。例如,与初级(大学)教育相比,高等教育的失业几率比为 1.89(95%CI 1.59 至 2.26)。放弃和推迟医疗保健与男性年龄较大、女性和较高的教育程度有关。在国家层面,推迟医疗保健与更严格的政府抗 COVID 措施有关。

结论

失业和非 COVID-19 相关的医疗保健利用率下降在老年人中很常见,并且与几个社会人口学特征有关。失业似乎不成比例地影响了那些已经经济脆弱的人,这引发了对社会不平等加剧的担忧。

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