Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Rue Jean-Violette 29, 1205 Genève, Switzerland; Institute of Global Health, University of Geneva, Chemin des Mines 9, 1202 Genève, Switzerland.
Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Rue Jean-Violette 29, 1205 Genève, Switzerland.
Prev Med. 2022 Mar;156:106987. doi: 10.1016/j.ypmed.2022.106987. Epub 2022 Feb 9.
Health systems around the world continue to navigate through operational challenges surfaced by the coronavirus disease 2019 (COVID-19) pandemic; these have implications for access to healthcare. In this study, we estimate the prevalence and reasons for forgoing healthcare during the pandemic in Geneva, Switzerland; a country with a universal and mandatory private health insurance coverage.
Participants from a randomly selected population-based sample of the adult population living in the Canton of Geneva completed an online socio-demographic and lifestyle questionnaire between November 2020 and January 2021. The prevalence and reasons for forgoing healthcare since the beginning of the COVID-19 pandemic were examined descriptively, and logistic regression models were used to assess determinants for forgoing healthcare.
The study included 5397 participants, among which 8.0% reported having forgone healthcare since the beginning of the COVID-19 pandemic; participants with a disadvantaged financial situation (OR = 2.04; 95% CI: 1.56-2.65), and those reporting an average (OR = 2.54; 95% CI: 1.94-3.31) or poor health (OR = 4.40; 95% CI: 2.39-7.67) were more likely to forgo healthcare. The most common reasons to forgo healthcare were appointment cancellations by healthcare providers (53.9%), fear of infection (35.3%), and personal organizational issues (11.1%).
Our paper highlights the effects of the COVID-19 pandemic on access to healthcare and identifies population sub-groups at-risk for forgoing healthcare. These results necessitate public health efforts to ensure equitable and accessible healthcare as the COVID-19 pandemic continues.
全球卫生系统继续应对 2019 年冠状病毒病（COVID-19）大流行所带来的运营挑战；这些挑战对获得医疗保健产生了影响。在这项研究中，我们估计了瑞士日内瓦在大流行期间放弃医疗保健的流行率和原因；该国拥有普遍和强制性的私人医疗保险。
居住在日内瓦州的随机选择的基于人群的成年人口样本中的参与者在 2020 年 11 月至 2021 年 1 月之间完成了在线社会人口统计学和生活方式问卷。描述性地检查了自 COVID-19 大流行开始以来放弃医疗保健的流行率和原因，并使用逻辑回归模型评估了放弃医疗保健的决定因素。
该研究共纳入 5397 名参与者，其中 8.0%报告自 COVID-19 大流行开始以来放弃了医疗保健；经济状况较差的参与者（OR=2.04；95%CI：1.56-2.65），以及报告平均（OR=2.54；95%CI：1.94-3.31）或较差健康状况的参与者（OR=4.40；95%CI：2.39-7.67）更有可能放弃医疗保健。放弃医疗保健的最常见原因是医疗服务提供者取消预约（53.9%）、担心感染（35.3%）和个人组织问题（11.1%）。
我们的论文强调了 COVID-19 大流行对获得医疗保健的影响，并确定了面临放弃医疗保健风险的人群亚组。这些结果需要公共卫生努力，以确保在 COVID-19 大流行继续时提供公平和可获得的医疗保健。
