Delayed medical care and its perceived health impact among US older adults during the COVID-19 pandemic.

ABSTRACT

BACKGROUND: Medical care delivery has been substantially disrupted during the coronavirus disease 2019 (COVID-19) pandemic, leading to delays in medical care, particularly among older adults. Less is known about how these delays have affected different segments of this population. Understanding the negative health consequences older adults face from delayed care will provide critical insights into the longer-term population health needs following the pandemic. METHODS: We used data from a COVID-19 substudy embedded in a nationally representative longitudinal study of older adults, the National Social Life, Health, and Aging Project. Data were collected between September 14, 2020, and January 27, 2021. Two thousand six hundred seventy-two individuals responded to the survey. Using logistic and multinomial logistic regressions, we determined respondent-level characteristics associated with delayed medical care, experiencing a negative impact on physical health from delayed care, and with reporting worsening physical health during the pandemic. RESULTS: Nearly, one-third (32.8%) of older adults reported delayed medical care during the pandemic. Female sex, higher levels of education, greater concerns about the pandemic, and poorer self-rated physical health were associated with delayed medical care. Blacks and those who are 70 and older were less likely to report delayed care. Among those whose care was delayed, 76.5% reported having already recovered delayed care. Nearly one in five (17.6%) reported that delayed care negatively affected their health. Older adults with worse self-rated physical and mental health or who had not fully recovered delayed care were more likely to report perceived negative health impacts from the delay. Regardless of delayed medical care, 10.2% reported worse physical health during the pandemic. CONCLUSIONS: One-third of older adults experienced care delays during the pandemic. Despite high rates of care recovery, nearly one in five older adults who experienced delayed care reported being negatively affected. Strategies must be developed to reach these vulnerable patients to increase their healthcare utilization.