Jones Alyssa N, Power Melinda C
Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.
J Med Access. 2023 Oct 21;7:27550834231202860. doi: 10.1177/27550834231202860. eCollection 2023 Jan-Dec.
During the first year of the COVID-19 pandemic, more than one-third of US older adults (aged 65 years and older) reported delaying medical care. Delayed health care may exacerbate short- and long-term health changes in older adults. Older adults more likely to delay health care may benefit from targeted follow-up to return these individuals to the health care system.
The aim of this study was to describe pre-pandemic sociodemographic, psychological, cognitive, and medical factors associated with delayed health care among US older adults during the COVID-19 pandemic.
We conducted a secondary analysis of 2905 participants from the National Health and Aging Trends Study (NHATS), a nationally representative, prospective cohort of US older adult Medicare beneficiaries.
Pre-pandemic factors were reported at the Round 9 interview (2019). Delayed health care, including medical (e.g. usual doctor) and supplementary (e.g. dental) care, was reported on the COVID-19 questionnaire (2020). We calculated adjusted odds ratios using weighted logistic regression, accounting for the NHATS sampling design.
Overall, 40% of participants reported delayed care. After adjustment, female participants and those reporting fair (vs good) health were consistently more likely to delay health care while persons with lower income or excellent health were less likely to delay care. Other associations varied by care type.
Women and those with higher income or fair health before the COVID-19 pandemic were more likely to delay care during the pandemic. Our results may inform targeted outreach to older adults who delayed care during the COVID-19 pandemic, or other disruptions to the health care system, to return these individuals to care and promote better management of their health needs.
在新冠疫情的第一年，超过三分之一的美国老年人（65岁及以上）报告称推迟了医疗护理。延迟的医疗护理可能会加剧老年人短期和长期的健康变化。更有可能推迟医疗护理的老年人可能会从有针对性的随访中受益，以便让这些人重新回到医疗体系。
本研究的目的是描述新冠疫情期间美国老年人推迟医疗护理与疫情前社会人口学、心理、认知和医学因素之间的关联。
我们对来自国家健康与老龄化趋势研究（NHATS）的2905名参与者进行了二次分析，该研究是一项具有全国代表性的美国老年医疗保险受益人的前瞻性队列研究。
疫情前的因素在第9轮访谈（2019年）中报告。延迟的医疗护理，包括医疗护理（如常规医生诊疗）和补充护理（如牙科护理），在新冠疫情调查问卷（2020年）中报告。我们使用加权逻辑回归计算调整后的比值比，并考虑了NHATS抽样设计。
总体而言，40%的参与者报告称推迟了护理。调整后，女性参与者以及报告健康状况为一般（而非良好）的人一直更有可能推迟医疗护理，而收入较低或健康状况极佳的人推迟护理的可能性较小。其他关联因护理类型而异。
在新冠疫情之前，女性以及收入较高或健康状况一般的人在疫情期间更有可能推迟护理。我们的结果可能为针对在新冠疫情期间或医疗体系受到其他干扰时推迟护理的老年人进行有针对性的宣传提供信息，以便让这些人重新接受护理并更好地管理他们的健康需求。
