Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain.
Department of Economics, Faculty of Economics and Business, University of Barcelona, 08034 Barcelona, Spain.
Int J Environ Res Public Health. 2021 Aug 31;18(17):9177. doi: 10.3390/ijerph18179177.
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.
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).
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.
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.
由于 COVID-19 大流行，医疗服务中断，许多非紧急医疗治疗和预约被推迟或拒绝，这预计对非急性健康状况产生巨大影响，特别是在老年人等弱势群体中。应关注大流行期间未满足需求相关的公平问题。
我们使用欧洲健康、老龄化和退休调查（SHARE）的数据，计算了集中指数，以确定 50 岁以上人群因 COVID-19 而推迟和拒绝医疗保健的未满足需求方面的收入相关不平等和水平不公平。
很少有国家在推迟、重新安排或拒绝治疗和医疗预约方面表现出显著的收入相关不平等，通常有利于富人。只有爱沙尼亚、意大利和罗马尼亚在推迟的医疗保健方面表现出显著的水平不公平（HI），这显然有利于穷人。在意大利、波兰和希腊，拒绝医疗保健的明显有利于富人的不平等现象。
尽管在 COVID-19 大流行的早期阶段，大多数国家的欧洲老年人未满足需求方面没有明显的重要收入相关水平不公平，但其中一些国家必须仔细监测获得医疗保健的障碍。诊断和治疗的延迟最终可能会导致不良的健康结果、生活质量下降，甚至扩大老年人之间的社会经济健康不平等。
