Postponed healthcare in The Netherlands during the COVID-19 pandemic and its impact on self-reported health

Kirsten Visscher; Lisanne H J A Kouwenberg; Marije Oosterhoff; Adriënne H Rotteveel; G Ardine de Wit

doi:10.3389/frhs.2023.1181532

Postponed healthcare in The Netherlands during the COVID-19 pandemic and its impact on self-reported health

Front Health Serv. 2023 Jun 23:3:1181532. doi: 10.3389/frhs.2023.1181532. eCollection 2023.

Authors

Kirsten Visscher^#¹, Lisanne H J A Kouwenberg^#^{1

2}, Marije Oosterhoff¹, Adriënne H Rotteveel¹, G Ardine de Wit^{1

3}

Affiliations

¹ Centre for Nutrition, Prevention and Healthcare, National Institute for Public Health and the Environment, Bilthoven, Netherlands.
² Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands.
³ Faculty of Science, Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.

^# Contributed equally.

Abstract

Background: Healthcare services have been seriously disrupted during the COVID-19 pandemic. The aim of this study was to examine the extent to which Dutch citizens have experienced postponed healthcare and how this affected their self-reported health. In addition, individual characteristics that were associated with experiencing postponed healthcare and with self-reported negative health effects were investigated.

Methods: An online survey about postponed healthcare and its consequences was developed, and sent out to participants of the Dutch LISS (Longitudinal Internet Studies for the Social Sciences) panel (n = 2.043). Data were collected in August 2022. Multivariable logistic regression analyses were carried out to explore characteristics associated with postponed care and self-reported negative health outcomes.

Results: Of the total population surveyed, 31% of the panel experienced postponed healthcare, either initiated by the healthcare provider (14%), on their own initiative (12%) or as a combination of both (5%). Postponed healthcare was associated with being female (OR = 1.61; 95% CI = 1.32; 1.96), presence of chronic diseases (OR = 1.55, 95% CI = 1.24; 1.95), high income (OR = 0.62, 95% CI = 0.48; 0.80) and worse self-reported health (poor vs. excellent OR = 2.88, 95% CI = 1.17; 7.11). Overall, 40% experienced temporary or permanent self-reported negative health effects due to postponed care. Negative health effects as a result of postponed care were associated with presence of chronic conditions and low income levels (p < 0.05). More respondents with worse self-reported health and foregone healthcare reported permanent health effects as compared to those with temporary health effects (p < 0.05).

Discussion: People with an impaired health status are most likely to experiencing postponed healthcare and negative health consequences as a result. Furthermore, those with negative health consequences decided to forego health by themselves more often. As part of long-term plans to maintain the accessibility of healthcare services, specific attention should be paid to reaching out to people with an impaired health status.

Keywords: COVID-19; dental care; health effects; hospital care; paramedical care; postponement of healthcare; primary care; survey.

Grants and funding

The National Institute of Public Health and the Environment (RIVM) received a grant from the Dutch Ministry of Health, Welfare and Sports for the COVID-19 research program, with which this study was funded.