Economic vulnerability and unmet healthcare needs among the population aged 50 + years during the COVID-19 pandemic in Europe.

IF 3.7 2区社会学 Q1 GERONTOLOGY European Journal of Ageing Pub Date : 2021-09-05 eCollection Date: 2022-12-01 DOI:10.1007/s10433-021-00645-3

Louis Arnault, Florence Jusot, Thomas Renaud

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Abstract

This study investigated the effect of economic vulnerability on unmet needs during the first wave of the coronavirus disease 2019 (COVID-19) epidemic in Europe among adults aged 50 years and older using data from the regular administration of the Survey of Health, Ageing and Retirement in Europe (SHARE) and the specific telephone survey administered regarding COVID-19 (SHARE Corona Survey). It addressed three main research questions: Did people who were in difficult economic situations before the epidemic face more barriers to accessing healthcare than others? If so, to what extent can these discrepancies be attributed to initial differences in health status, use of care, income or education between vulnerable individuals and non-vulnerable individuals or to differential effects of the pandemic on these groups? Did the effect of economic vulnerability with regard to unmet needs during the pandemic differ across countries? Unmet healthcare needs are characterised by three types of behaviours likely to be induced by the pandemic: forgoing care for fear of contracting COVID-19, having pre-scheduled care postponed and being unable to obtain medical appointments or treatments when needed. Our results substantiate the existence of significant differences in accessing healthcare during the pandemic according to economic vulnerability and of cumulative effects of economic and medical vulnerabilities: the impact of economic vulnerability is notably stronger among those who were in poor health before the outbreak and thus the oldest individuals. The cross-country comparison highlighted heterogeneous effects of economic vulnerability on forgoing care and having care postponed among countries, which are not comparable to the initial cross-country differences in social inequalities in access to healthcare.

Supplementary information: The online version contains supplementary material available at 10.1007/s10433-021-00645-3.

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COVID-19 大流行期间欧洲 50 岁以上人口的经济脆弱性和未满足的医疗保健需求。

本研究利用定期进行的欧洲健康、老龄和退休调查（SHARE）以及针对 COVID-19 进行的专门电话调查（SHARE Corona Survey）中的数据，调查了在欧洲冠状病毒病 2019（COVID-19）第一波流行期间，经济脆弱性对 50 岁及以上成年人未满足需求的影响。它涉及三个主要研究问题：疫情发生前经济状况不佳的人是否比其他人在获得医疗服务方面面临更多障碍？如果是，这些差异在多大程度上可归因于弱势人群与非弱势人群在健康状况、医疗服务使用、收入或教育方面的初始差异，或归因于疫情对这些群体的不同影响？在大流行期间，经济脆弱性对未满足需求的影响在不同国家是否有所不同？未满足的医疗保健需求表现为可能由大流行病引起的三类行为：因害怕感染 COVID-19而放弃治疗、推迟预先安排的治疗以及无法在需要时就诊或接受治疗。我们的研究结果证明，在大流行期间，不同的经济弱势人群在获得医疗服务方面存在显著差异，而且经济弱势和医疗弱势的累积效应也存在显著差异：经济弱势对疫情爆发前健康状况较差的人群以及年龄最大的人群的影响明显更大。跨国比较凸显了经济脆弱性对各国放弃治疗和推迟治疗的不同影响，这种影响与最初各国在获得医疗保健方面的社会不平等差异无法相比：在线版本包含补充材料，可查阅 10.1007/s10433-021-00645-3。

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来源期刊

European Journal of Ageing GERONTOLOGY-

CiteScore

6.50

自引率

7.90%

发文量

期刊介绍： The European Journal of Ageing: Social, Behavioural and Health Perspectives is an interdisciplinary journal devoted to the understanding of ageing in European societies and the world over. EJA publishes original articles on the social, behavioral and population health aspects of ageing and encourages an integrated approach between these aspects. Emphasis is put on publishing empirical research (including meta-analyses), but conceptual papers (including narrative reviews) and methodological contributions will also be considered. EJA welcomes expert opinions on critical issues in ageing. By stimulating communication between researchers and those using research findings, it aims to contribute to the formulation of better policies and the development of better practice in serving older adults. To further specify, with the term ''social'' is meant the full scope of social science of ageing related research from the micro to the macro level of analysis. With the term ''behavioural'' the full scope of psychological ageing research including life span approaches based on a range of age groups from young to old is envisaged. The term ''population health-related'' denotes social-epidemiological and public health oriented research including research on functional health in the widest possible sense.