Department of Macroeconomics and Economic Development, Faculty of Economics and Business, University of Zagreb, Zagreb, Croatia.
Front Public Health. 2022 Jul 15;10:921379. doi: 10.3389/fpubh.2022.921379. eCollection 2022.
The COVID-19 pandemic exacerbated issues regarding access to healthcare for older people, by far the most vulnerable population group. In particular, older adults avoided seeking medical treatment for fear of infection or had their medical treatments postponed or denied by health facilities or health professionals. In response, remote medical services were recognized as an essential adjustment mechanism to maintain the continuity of healthcare provision. Using the SHARE Corona Survey data, we estimate logistic and multilevel regression models for the remote care of 44,152 persons aged 50 and over in 27 European countries and Israel. Our findings suggest that those aged 80+ were the least likely to use remote healthcare. However, women, better educated individuals, older adults who lived in urban areas, those with no financial strain, and active Internet users used remote medical consultations more often. Those who reported poor or fair health status, two or more chronic diseases, or hospitalization in the last 12 months were significantly more likely to use remote healthcare. Furthermore, remote medical consultations were more frequent for those who had their healthcare postponed or went without it due to fear of coronavirus infection. Finally, older adults used remote care more frequently in countries with less healthcare coverage and lower health expenditures. Health systems should prioritize vulnerable groups in maintaining continuity in access to healthcare, despite the availability of remote care. Policymakers should improve telemedicine regulation and offer incentives for providers of remote healthcare services by adapting reimbursement policies. Remote medical care could play an important role in maintaining healthcare access for older adults and increasing health systems' preparedness in future health emergencies.
新冠疫情大流行使老年人（迄今为止最脆弱的人群）获得医疗保健的问题更加恶化。特别是，老年人因为害怕感染而避免就医，或者他们的治疗被医疗机构或医疗专业人员推迟或拒绝。为此，远程医疗服务被认为是维持医疗保健提供连续性的重要调整机制。我们利用 SHARE Corona 调查数据，针对 27 个欧洲国家和以色列的 44152 名 50 岁及以上人群，估计了远程护理的逻辑回归和多层回归模型。我们的研究结果表明，80 岁以上的老年人最不可能使用远程医疗。然而，女性、受教育程度较高、居住在城市地区、没有经济压力和经常使用互联网的老年人更经常使用远程医疗咨询。报告健康状况较差或一般、患有两种或两种以上慢性病或在过去 12 个月内住院的老年人更有可能使用远程医疗。此外，由于担心冠状病毒感染而推迟或放弃医疗的人更频繁地使用远程医疗。最后，在医疗保健覆盖率较低和医疗支出较低的国家，老年人更频繁地使用远程护理。尽管有远程医疗服务，卫生系统仍应优先考虑弱势群体，以维持他们获得医疗保健的连续性。政策制定者应通过调整报销政策，改善远程医疗监管并为远程医疗服务提供者提供激励措施。远程医疗护理可以在维持老年人获得医疗保健方面发挥重要作用，并提高卫生系统在未来卫生紧急情况下的准备程度。
