Reduced access to care among older American adults during CoVID-19 pandemic: Results from a prospective cohort study

Abstract

Background: Reduced access to routine care can lead to higher morbidity and mortality among older adults. We assessed the extent of reduced access to care among older American adults during the COVID-19 pandemic, identified predictors and reasons for reduced access. Materials and methods: Using publicly available data from the COVID-19 module (interim release) of the Health and Retirement Study, we undertook descriptive analyses of older adults stratified by socio-demographic characteristics. Associations between reduced access to care and predictors were estimated using a multivariable logistic regression model. Results: 30.2% of respondents delayed or avoided care during the pandemic. Reduced access was more likely to be reported by respondents that were female, younger, educated, not receiving social security benefits, with limitations in daily activities and three preexisting conditions. In terms of the reasons, the majority of the respondents (45.9%) reported that their visit was either cancelled or rescheduled by the provider; 13.9% thought they could wait, 10.9% could not get an appointment, 9.1% found it unaffordable, and 7.4% were afraid to visit the provider. Respondents reported of reduced access to doctor’s visits, surgery, prescription filling, and dental care. Conclusions: We suggest urgent attention on improving access to care for older adults during the pandemic. For nonemergency conditions and routine care that can be delivered virtually, telehealth services can be strengthened. Additionally, health messaging can reemphasize that neglecting medical care might lead to increased morbidity and mortality among older adults from preexisting illnesses. Keywords: Older adults; Access to care; COVID-19; Health and retirement study

A Cross-Sectional Study of Psychosocial Factors and Sickness Presenteeism in Japanese Workers During the COVID-19 Pandemic

“…During a COVID-19 epidemic, workers may be more hesitant to report their health condition to the company when they are not feeling well. Reports worldwide have also noted the interruption of treatment for previously controlled diseases during the COVID-19 outbreak, 19,20 which also acts to increase sickness presenteeism. Furthermore, the management of sickness presenteeism is important in terms of preventing the spread of infection.…”

Socio-ecological determinants of older people’s mental health and well-being during COVID-19: A qualitative analysis within the Irish context

“…The influence of these risk factors is not limited to the prevention and course of a COVID-19 infection, but significantly contributes to broader economic and social consequences that may affect older people’s quality of life and well-being in the short- and long-term. A deterioration in older people’s mental health and well-being during the pandemic may also be compounded by previous social isolation and loneliness, increased sedentary behaviors and limited access to healthcare services for non-COVID needs ( 5 – 7 ). Additionally, age-specific public health measures, such as exclusive hours to carry on essential activities and sheltering-in-place (also known as cocooning), have created among older individuals ambivalent emotions of feeling protected and feeling ostracized ( 8 ).…”

Treatment interruption is a risk factor for sickness presenteeism: A large-scale cross-sectional study during the COVID-19 pandemic

“…Interruption to medical care is an important problem in the COVID‐19 pandemic. Access to necessary routine medical care and medical resources is reportedly being affected in many countries around the world 17–19 . In Japan, there are data showing that the number of prescriptions issued has decreased 20 .…”