Changes in Access to Health Services during the COVID-19 Pandemic: A Scoping Review

Abstract

The COVID-19 pandemic and the measures adopted are having a profound impact on a major goal of public healthcare systems: universal access to health services. The objective is to synthesize the available knowledge on access to health care for non-COVID-19 conditions and to identify knowledge gaps. A scoping review was conducted searching different databases (Medline, Google Scholar, etc.) for original articles published between December 2019 and September 2021. A total of 53 articles were selected and analyzed using the Aday and Andersen framework as a guide. Of these, 37 analyzed changes in levels of use of health services, 15 focused on the influencing factors and barriers to access, and 1 studied both aspects. Most focused on specific diseases and the early stages of the pandemic, based on a review of records. Analyses of the impact on primary care services’ use, unmet needs or inequalities in access were scarce. A generalized reduction in the use of health services was described. The most frequent access barrier described for non-COVID-19 conditions related to the services was a lack of resources, while barriers related to the population were predisposing (fear of contagion, stigma, or anticipating barriers) and enabling characteristics (worse socioeconomic status and an increase in technological barriers). In conclusion, our results show a general reduction in services’ use in the early stages of the pandemic, as well as new barriers to access and the exacerbation of existing ones. In view of these results, more studies are required on the subsequent stages of the pandemic, to shed more light on the factors that have influenced access and the pandemic’s impact on equity of access.

Video-Assisted Stylet Intubation with a Plastic Sheet Barrier, a Safe and Simple Technique for Tracheal Intubation of COVID-19 Patients

“…Healthcare utilization and services were dramatically constrained during the COVID-19 pandemic [ 18 , 19 , 20 , 21 ], and it became imperative to protect healthcare workers against infection when caring for COVID-infected patients. In-hospital spread of Omicron infection occurred at our institution in April 2022, after a huge surge of cases in the general population of Taiwan ( Figure 1 ).…”

Association Between Perceived Access to Healthcare and the Perception of Illness Among Peruvian Adults with Chronic Diseases During COVID-19 Pandemic

“… 40 The COVID-19 pandemic has greatly affected the provision of care for patients with chronic diseases. 41 So, there is an urgent need to develop innovative ways of caring for patients with chronic diseases during the pandemic. Significant development and integration of digital technology could be the most feasible solution.…”

Impact of COVID-19 pandemic on hemodialysis access thrombosis

“…Prior studies found that 40.9% of adults did not seek proper medical care and 12% opted not to get urgent or emergency care for fear of COVID-19. 5 , 25 Our own patients have expressed concern during the dialysis rounds when angiogram was offered to evaluate the access based on abnormal physical exam finding. Our patients were able to be scheduled for the outpatient procedures including angiograms and thrombectomy if indicated, but it might have taken longer time to schedule because of hesitancy in fear of contracting COVID-19 and due to requirement for a COVID-19 test prior to the procedure.…”