ISEG, Lisbon School of Economics and Management, Lisbon, Portugal.
CEISUC, Centre of Studies and Research in Health of the University of Coimbra, Coimbra, Portugal.
BMC Health Serv Res. 2022 Feb 12;22(1):182. doi: 10.1186/s12913-022-07563-9.
During the COVID-19 pandemic the utilization of health services has changed. People were living in a very different social, economic and epidemiological context. Unmet health care is expected to happen. The purposes of this work are i) to compare the differences between unmet care across countries, ii) to find the main factors which are associated with unmet health care, which includes giving up and postponing medical care, as well as denial of medical care provision by the health services, and iii) to determine if health systems' characteristics and government decisions on lockdown were related to unmet care.
We have used the most recent dataset collected by the SHARE-COVID Survey during the summer of 2020. These data cover all EU countries and are applied to people over 50. We have estimated a set of logistic regressions to explain unmet health care.
The results indicate that women, people who are slightly younger, with higher education and income, who find it hard to make ends meet each month, and people with poorer health were more likely to experience unmet health care. We also found that in health systems with high out-of-pocket payments people are more likely to give up health care while in countries with previous high levels of unmet health needs this likelihood was the opposite; people in countries with a high number of beds per capita and with a Beveridge-type health system were reporting less postponement of health care.
Some policy measures may be suggested such as social and economic measures to mitigate loss of income, expansion of the points and forms of access to health care to improve utilisation.
在 COVID-19 大流行期间,卫生服务的利用发生了变化。人们生活在一个非常不同的社会、经济和流行病学环境中。预计会出现未满足的医疗需求。这项工作的目的是:i)比较各国未满足的医疗需求差异;ii)找出与未满足的医疗保健相关的主要因素,包括放弃和推迟医疗保健以及卫生服务拒绝提供医疗保健;iii)确定卫生系统的特征和政府对封锁的决策是否与未满足的医疗保健有关。
我们使用了 SHARE-COVID 调查在 2020 年夏季收集的最新数据集。这些数据涵盖了所有欧盟国家,适用于 50 岁以上的人群。我们估计了一组逻辑回归模型来解释未满足的医疗需求。
结果表明,女性、稍年轻的人、受教育程度和收入较高、每月收支相抵有困难、健康状况较差的人更有可能经历未满足的医疗需求。我们还发现,在高自费支付的卫生系统中,人们更有可能放弃医疗保健,而在以前未满足医疗需求水平较高的国家,这种可能性则相反;人均病床数较高、采用贝弗里奇式卫生系统的国家报告的医疗保健推迟情况较少。
可以提出一些政策措施,例如减轻收入损失的社会和经济措施,扩大获得医疗保健的途径和形式以提高利用率。