荷兰在新冠疫情期间推迟的医疗保健及其对自我报告健康状况的影响。
Postponed healthcare in The Netherlands during the COVID-19 pandemic and its impact on self-reported health.
作者信息
Visscher Kirsten, Kouwenberg Lisanne H J A, Oosterhoff Marije, Rotteveel Adriënne H, de Wit G Ardine
机构信息
Centre for Nutrition, Prevention and Healthcare, National Institute for Public Health and the Environment, Bilthoven, Netherlands.
Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands.
出版信息
Front Health Serv. 2023 Jun 23;3:1181532. doi: 10.3389/frhs.2023.1181532. eCollection 2023.
BACKGROUND
Healthcare services have been seriously disrupted during the COVID-19 pandemic. The aim of this study was to examine the extent to which Dutch citizens have experienced postponed healthcare and how this affected their self-reported health. In addition, individual characteristics that were associated with experiencing postponed healthcare and with self-reported negative health effects were investigated.
METHODS
An online survey about postponed healthcare and its consequences was developed, and sent out to participants of the Dutch LISS (Longitudinal Internet Studies for the Social Sciences) panel ( = 2.043). Data were collected in August 2022. Multivariable logistic regression analyses were carried out to explore characteristics associated with postponed care and self-reported negative health outcomes.
RESULTS
Of the total population surveyed, 31% of the panel experienced postponed healthcare, either initiated by the healthcare provider (14%), on their own initiative (12%) or as a combination of both (5%). Postponed healthcare was associated with being female (OR = 1.61; 95% CI = 1.32; 1.96), presence of chronic diseases (OR = 1.55, 95% CI = 1.24; 1.95), high income (OR = 0.62, 95% CI = 0.48; 0.80) and worse self-reported health (poor vs. excellent OR = 2.88, 95% CI = 1.17; 7.11). Overall, 40% experienced temporary or permanent self-reported negative health effects due to postponed care. Negative health effects as a result of postponed care were associated with presence of chronic conditions and low income levels ( < 0.05). More respondents with worse self-reported health and foregone healthcare reported permanent health effects as compared to those with temporary health effects ( < 0.05).
DISCUSSION
People with an impaired health status are most likely to experiencing postponed healthcare and negative health consequences as a result. Furthermore, those with negative health consequences decided to forego health by themselves more often. As part of long-term plans to maintain the accessibility of healthcare services, specific attention should be paid to reaching out to people with an impaired health status.
背景
在新冠疫情期间，医疗服务受到了严重干扰。本研究的目的是调查荷兰公民经历医疗推迟的程度，以及这对他们自我报告的健康状况有何影响。此外，还调查了与经历医疗推迟以及自我报告的负面健康影响相关的个体特征。
方法
开展了一项关于医疗推迟及其后果的在线调查，并发送给荷兰社会科学纵向互联网研究（LISS）小组的参与者（n = 2043）。数据于2022年8月收集。进行多变量逻辑回归分析，以探索与推迟医疗和自我报告的负面健康结果相关的特征。
结果
在接受调查的总人口中，31%的小组成员经历了医疗推迟，其中由医疗服务提供者发起的占14%，自行决定的占12%，两者兼有的占5%。医疗推迟与女性（比值比[OR]=1.61；95%置信区间[CI]=1.32；1.96）、患有慢性病（OR = 1.55，95% CI = 1.24；1.95）、高收入（OR = 0.62，95% CI = 0.48；0.80）以及自我报告的健康状况较差（差与优相比，OR = 2.88，95% CI = 1.17；7.11）有关。总体而言，40%的人因推迟医疗而经历了自我报告的暂时或永久负面健康影响。因推迟医疗导致的负面健康影响与患有慢性病和低收入水平有关（P < 0.05）。与有暂时健康影响的人相比，更多自我报告健康状况较差且放弃医疗的受访者报告有永久健康影响（P < 0.05）。
讨论
健康状况受损的人最有可能经历医疗推迟并因此产生负面健康后果。此外，那些有负面健康后果的人更常自行决定放弃医疗。作为维持医疗服务可及性的长期计划的一部分，应特别关注接触健康状况受损的人群。
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