Avoidance of Healthcare Utilization in South Korea during the Coronavirus Disease 2019 (COVID-19) Pandemic

Abstract

Avoidance of healthcare utilization among the general population during pandemic outbreaks has been observed and it can lead to a negative impact on population health. The object of this study is to examine the influence of socio-demographic and health-related factors on the avoidance of healthcare utilization during the global outbreak of a novel coronavirus (COVID-19) in 2020. Data were collected through an online survey four weeks after the Korea Centers for Disease Control and Prevention (KCDC) confirmed the first case in South Korea; 1000 subjects were included in the analysis. The logit model for regression was used to analyze the associations between sociodemographic and health-related factors regarding the avoidance of healthcare utilization. Among the participants, 73.2% avoided healthcare utilization, and there was no significant difference in the prevalence of healthcare avoidance between groups with (72.0%) and without (74.9%) an underlying disease. Sociodemographic characteristics (e.g., gender, age, income level, and residential area) were related to healthcare avoidance. Among the investigated influencing factors, residential areas highly affected by COVID-19 (i.e., Daegu/Gyeoungbuk region) had the most significant effect on healthcare avoidance. This study found a high prevalence of healthcare avoidance among the general population who under-utilized healthcare resources during the COVID-19 outbreak. However, the results reveal that not all societal groups share the burden of healthcare avoidance equally, with it disproportionately affecting those with certain sociodemographic characteristics. This study can inform healthcare under-utilization patterns during emerging infectious disease outbreaks and provide information to public health emergency management for implementing strategies necessary to improve the preparedness of the healthcare system.

Prevalence and factors associated with non-use of health services in the Peruvian population with COVID-19 symptomatology: a secondary analysis of the 2020 National Household Survey

“…This situation is not alien to other latitudes. In South Korea, a study reported that 73.2% of study participants in that country avoided using health services during the pandemic [22]. On the other hand, in China, hospital visits for any cause fell by 51% after the COVID-19 pandemic [23].…”

Intention-Based Critical Factors Affecting Willingness to Adopt Novel Coronavirus Prevention in Pakistan: Implications for Future Pandemics

“…In this way, the expansion of pandemics could be controlled. In the same vein, Lee and You [ 71 ] investigated and found a significant impact of health factors on the avoidance of healthcare use in South Korea. Hashiguchi et al [ 72 ] analyzed the association among health risk, productivity, and work motivation among the construction workforce in Japan.…”

Factors Associated with the Patient’s Decision to Avoid Healthcare during the COVID-19 Pandemic

“…The latter phenomenon is known as healthcare avoidance and was previously described in response to a traumatic or threatening situation like this pandemic [ 6 , 7 ]. Healthcare avoidance can be characterised as cancelling appointments, nonadherence to treatment and delaying or avoiding medical care due to fear or denial of symptoms and diagnosis, among other factors [ 6 , 8 , 9 ]. The impact of COVID-19 is yet to be fully determined, but existing evidence suggests that changes in healthcare utilisation are in the pathway of COVID-19 indirect effects [ 3 ].…”

“…The frequency of healthcare avoidance during the pandemic and potential drivers were analysed in previous studies [ 4 , 7 , 8 , 10 , 11 , 12 ]. The proportion of individuals who avoid or delay healthcare has increased in several countries, regardless of the COVID-19 incidence rate of the country, indicating a global problem.…”

“…Reasons to avoid healthcare included the closure of medical offices, fear of contracting COVID-19 and financial difficulties resulting from the pandemic [ 7 , 10 ]. Other factors related to healthcare avoidance are poor health perception, the number of comorbidities and living in highly COVID-19-affected residential areas [ 8 , 11 , 12 ]. In addition, healthcare avoidance was linked to risk perception, a subjective psychological construct influenced by cognitive, emotional and cultural factors [ 16 ].…”