Health care seeking due to COVID-19 related symptoms and health care cancellations among older Brazilian adults: the ELSI-COVID-19 initiative

Abstract

The continent of the Americas has the greatest number of people infected and deaths associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the world. Brazil occupies the 2nd position in numbers of infected cases and deaths, preceded only by the United States. Older adults and those with pre-existing chronic illnesses are more vulnerable to the consequences of the virus. The SARS-CoV-2 epidemic has serious consequences for health services. Therefore, an assessment of the pandemic’s effect on the older Brazilian population is urgently needed. The study examines the prevalence of COVID-19 related symptoms, care-seeking, and cancellation of surgery or other scheduled medical care among a nationally representative sample of Brazilians aged 50 and over derived from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) and a telephone follow-up survey (the ELSI-COVID-19 initiative) between late May and early June 2020. About 10.4% of older adults reported any fever, dry cough or difficulty breathing in the 30 days prior to the interview, with the highest prevalence in the North region (50%). Among individuals with symptoms, only 33.6% sought care. Individuals living in the South or Southeast regions were significantly less likely to seek care for COVID-19 related symptoms. Nearly one in six participants had to cancel scheduled surgery or other medical care; this proportion was higher among women, those with more education, and people with multiple chronic conditions. This paper is among the first to investigate the effect of COVID-19 on health care use in Brazil among older adults. Results highlight the need to adapt health care delivery (such as through telemedicine) to ensure the continuity of care as well as the urgent need for wide dissemination of information to guide the population on disease prevention measures and how to obtain healthcare when needed.

Community risk perception and health-seeking behavior in the era of COVID-19 among adult residents of Harari regional state, eastern Ethiopia

“…The prevalence of healthcare-seeking behavior in the current study is consistent with the previous findings reported in Brazil (33.6%), 20 Bangladesh (35.1%), 26 and China (35.4%). 27 However, the result of the current study is lower than the findings reported in Hubei, China (85.7%), 28 Iran (75.2%), 29 United Kingdom (64.3%), 30 and Egypt (60%).…”

“…Among the study participants (1296), 781 (60.3%) answered that COVID-19 could be transmitted via inhalation of a droplet from infected people, which was lower than the finding of another study conducted in China, which reported that 2734 (96.1%) of the respondents knew that COVID-19 could be transmitted from person to person. 20 Similarly, the current study found 752 (58.0%) of the respondents reported airborne as a transmission route for COVID-19; this was lower than the finding of another study conducted in China, which found that 2730 (96.0%) of respondents reported breathing and droplets as a transmission route for COVID-19. 20 The variation may be related to the difference in sources of information, educational status of the respondents, and timely access to the information that can all play a major role in controlling the COVID-19 pandemic.…”

“… 20 Similarly, the current study found 752 (58.0%) of the respondents reported airborne as a transmission route for COVID-19; this was lower than the finding of another study conducted in China, which found that 2730 (96.0%) of respondents reported breathing and droplets as a transmission route for COVID-19. 20 The variation may be related to the difference in sources of information, educational status of the respondents, and timely access to the information that can all play a major role in controlling the COVID-19 pandemic.…”

A cross-sectional study of the relationship between delayed healthcare utilisation and chronic conditions among older adults during the COVID-19 pandemic in Ireland

“…This study found that older adults with two or more chronic conditions were more likely to have healthcare delayed during the early months of the COVID-19 pandemic. This is similar to findings reported in other studies, among different cohorts and in different healthcare systems (Macinko et al, 2020;Topriceanu et al, 2021). It is not surprising that people with chronic conditions were more likely to experience healthcare delay, given that they are likely to have a higher demand for healthcare services (Bähler et al, 2015;Glynn et al, 2011;McDaid, 2013).…”

“…Importantly, several studies have found that some groups have been impacted more than others. For example, people with more than one chronic condition (Macinko et al, 2020;Topriceanu et al, 2021;Zaninotto et al, 2020), females (Macinko et al, 2020;Topriceanu et al, 2021), people with higher levels of education (Macinko et al, 2020) and those who had visited the GP in the previous twelve months (Macinko et al, 2020), were more likely to experience some type of healthcare cancellation or delay.…”