Avoidance of health care during the COVID-19 pandemic in Geneva, Switzerland: a cross-sectional study in the general population

Lakshmi Krishna Menon, Viviane Richard, Carlos de Mestral, Helene Baysson, Ania Wisniak, Idris Guessous, Silvia Stringhini, for the Specchio-COVID19 group.
Forgoing healthcare during the COVID-19 pandemic in Geneva, Switzerland - A cross-sectional population-based study. Preventive Medicine 156 (2022) 106987, doi: 10.1016/j.ypmed.2022.106987

Summary:

Background : Healthcare systems have experienced major disruption worldwide due to the 2019 coronavirus (COVID-19) pandemic, with implications for access to healthcare. In this study, we estimate the prevalence and reasons for foregoing healthcare during the pandemic in the canton of Geneva, Switzerland; a country with private, universal and compulsory health insurance coverage.

Methods : The Specchio-COVID19 study is being conducted among a random sample of adults selected from the Geneva population. Between November 2020 and January 2021, participants completed an online questionnaire about their socio-demographic characteristics, lifestyle and health behaviours (including whether they had chosen or been forced to forego healthcare). The prevalence of and reasons for not seeking healthcare since the start of the COVID-19 pandemic were studied both descriptively and using logistic regression models to identify the determinants of not seeking healthcare.

Results: 5,397 participants were included in the study, 8.0% of whom reported having refused healthcare since the start of the COVID-19 pandemic. Participants in a situation of economic vulnerability (OR = 2.04; 95% CI: 1.56-2.65), and those reporting average health (OR = 2.54; 95% CI: 1.94-3.31) or poor health (OR = 4.40; 95% CI: 2.39-7.67) were more likely to forego healthcare. The most common reasons for foregoing care were cancellations of appointments by healthcare providers (53.9%), fear of infection (35.3%) and personal organisational problems (11.1%).

Conclusion: Our article highlights the effects of the COVID-19 pandemic on access to healthcare and identifies population groups at risk of foregoing healthcare. These results call for public health efforts to ensure equitable and accessible healthcare as the COVID-19 pandemic continues.

Link to the article in English