Factors influencing the likelihood of accessing healthcare during the COVID-19 pandemic in Ireland: lessons for the future

TL;DR

This study explores how people in Ireland avoided healthcare during the early stages of the COVID-19 pandemic, identifying vulnerable groups and factors that influenced their decisions.

Contribution

The study identifies specific demographic and health-related factors that increased the likelihood of avoiding healthcare during the pandemic.

Findings

15.7% of participants avoided contacting their G.P., and 8.4% avoided hospitals during the pandemic.

Women, individuals with recent adverse life events, and those at increased infection risk were more likely to avoid G.P. care.

Older adults, smokers, and those who feared catching COVID-19 were more likely to avoid hospital-based care.

Abstract

Implementation of public health measures during the first wave of the coronavirus disease (COVID-19) pandemic, including travel restrictions and physical distancing, may have impacted population behaviour in seeking medical care. Identifying barriers to accessing healthcare is important, especially for vulnerable groups.

Data were collected through a nationally representative cross-sectional telephone survey during the first period of easing of COVID-19 restrictions in May and June 2020. Secondary data analysis of the dataset was carried out to examine the factors influencing the likelihood of individuals avoiding General Practitioner (G.P.) and hospital-based care. Poisson regression analyses were conducted to estimate risk ratios with robust variance estimation of the association between selected demographic and self-reported health factors and the risk of avoiding G.P. and hospital-based healthcare.

Of the 969 participants, 152 (15.7%) deliberately avoided contacting their G.P. about non COVID-19 related concerns while 81 (8.4%) reported avoiding hospitals. Three groups, women (Rate Ratio (RR): 1.75, 95% Confidence Interval (CI): 1.28 – 2.40), individuals who reported experiencing an adverse life event within the last 3 months (RR: 1.79, 95% CI: 1.33 – 2.40), and those at an increased risk of infection (RR: 1.65, 95% CI: 1.06 – 2.58) were more likely to avoid contact with their G.P. Individuals at a higher risk of avoiding hospital-based care were those aged 50 – 59 years (RR: 2.27, 95% CI: 1.03 – 4.98) and 70 years+ (RR: 2.73, 95% CI: 1.24 – 6.01), individuals at an increased risk of infection (RR: 2.07, 95% CI: 1.20 – 3.56), smokers (RR: 1.68, 95% CI: 1.02 – 2.77) and those who agreed they were “likely to catch COVID-19” (RR: 2.80, 95% CI: 1.25 – 6.25).

These findings highlight the importance of public health awareness and education regarding accessing healthcare during a pandemic and should be considered in future pandemic preparedness.