Experience of Healthcare Access in Australia during the First Year of the COVID-19 Pandemic

Abstract

Changes in health-seeking behaviours and challenges in accessing care have been reported during the COVID-19 pandemic. This qualitative study examines Australian experiences related to healthcare access during the early months of the pandemic. The study aimed to identify key areas of concern as well as opportunities for services to prevent, manage and treat health concerns when normal access was disrupted. Fifty-nine semi-structured interviews were analysed. Participants were interviewed between August and December in 2020 over telephone or Zoom and were located across Australia. Rapid identification of themes with an audio recordings technique was used to generate themes from the data. Participants described a variety of influences on their health-seeking behaviours, resulting in decisions to delay care or being unable to reach care. Many individuals accessed health services via telehealth and offered a range of perceptions and views on its effectiveness and appropriateness. The findings illustrate that maintenance of health and access to healthcare and psychosocial support were compromised for some individuals, leading to negative impacts on both mental and physical health. This highlights the need to provide mechanisms to facilitate a person’s ability to access care in a timely manner during a pandemic.

Perceived access to general and mental healthcare in primary care in Colombia during COVID-19: A cross-sectional study

“…Although the emergencies rooms were available, patients dealt with the fear of COVID contagion in those sites. The intense public campaign for self-isolation and social distancing and the lack of clarity regarding the process changes implemented for healthcare provision left patients in the position of needing to decide whether they were candidates for healthcare (i.e., worthy of going to a hospital) and encumbering already crowded hospitals ( 1 , 2 , 6 , 7 , 9 ). This led to a number of patients refraining or postponing seeking any healthcare which, in some settings, has been correlated to avoidable mortality and poor outcomes for easily manageable health conditions ( 1 , 6 , 9 ).…”

“…The intense public campaign for self-isolation and social distancing and the lack of clarity regarding the process changes implemented for healthcare provision left patients in the position of needing to decide whether they were candidates for healthcare (i.e., worthy of going to a hospital) and encumbering already crowded hospitals ( 1 , 2 , 6 , 7 , 9 ). This led to a number of patients refraining or postponing seeking any healthcare which, in some settings, has been correlated to avoidable mortality and poor outcomes for easily manageable health conditions ( 1 , 6 , 9 ). Therefore, the high prevalence of perceived worsening in ease of access to healthcare during the pandemic reflects the struggle of both institutions and patients to maintain fluid communication regarding the steps to both mitigate the pandemic spread and address ongoing healthcare needs.…”

“…Mental healthcare is one service severely affected by this situation. Indeed, mental healthcare was often deemed as non-essential, resulting in numerous understaffed mental health units and care prioritized only for emergencies and critical cases ( 6 , 8 ). This magnified already existing barriers in access to mental healthcare, where not only already diagnosed patients struggled to maintain their ongoing care but non-diagnosed patients were undetected, undiagnosed, and untreated.…”

Police, permits and politics: Navigating life on Australia's state borders during the COVID‐19 pandemic

“…The situation is especially poignant when considering those who live in border communities. Both people and systems were highly adaptive at this time, for example telehealth availability and uptake increasing to enable health care access although it was not optimal for care of all conditions and people 8,9 …”

“…Both people and systems were highly adaptive at this time, for example telehealth availability and uptake increasing to enable health care access although it was not optimal for care of all conditions and people. 8,9 Even after 'border bubbles' were established, those living in regional Australia were vocal about cross-border restrictions as an obstacle to work. Although at the time of the interviews those who worked across the border could have border passes, these were not in place early in the pandemic period in Australia.…”