Forgoing healthcare during the COVID-19 pandemic in Geneva, Switzerland - a cross-sectional population-based study (preprint)

ABSTRACT

BackgroundHealth systems around the world continue to navigate through operational challenges surfaced by the COVID-19 pandemic; these have implications for access to healthcare. In this study, we estimate the prevalence and reasons for forgoing healthcare during the pandemic in Geneva, Switzerland; a country with a universal and mandatory private health insurance coverage. MethodsParticipants from a randomly selected population-based sample of the adult population living in the Canton of Geneva completed an online socio-demographic and lifestyle questionnaire between November 2020 and January 2021. The prevalence and reasons for forgoing healthcare since the beginning of the COVID-19 pandemic were examined descriptively, and logistic regression models were used to assess determinants for forgoing healthcare. ResultsThe study included 5,397 participants, among which 8.0% reported having forgone healthcare since the beginning of the COVID-19 pandemic; participants with a disadvantaged financial situation (OR=2.04; 95% CI 1.56-2.65), and those reporting an average (OR=2.55; 95% CI 1.94-3.32) or poor health (OR=4.40; 95% CI 2.40-7.68) were more likely to forgo healthcare. The most common reasons to forgo healthcare were appointment cancellations by healthcare providers (53.9%), fear of infection (35.3%), and personal organizational issues (11.1%). ConclusionOur paper highlights the effects of the COVID-19 pandemic on access to healthcare and identifies population sub-groups at-risk for forgoing healthcare. These results necessitate public health efforts to ensure equitable and accessible healthcare as the COVID-19 pandemic continues. HighlightsO_LI8% of the Geneva, Switzerland, adults renounced healthcare in the COVID-19 pandemic C_LIO_LIMain forgoing healthcare reasons are appointment cancellation and fear of infection C_LIO_LIUnderprivileged participants with poor health are more likely to forgo healthcare C_LI