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Inequalities in healthcare use during the COVID-19 pandemic

Author

Listed:
  • Arun Frey

    (Leverhulme Centre for Demographic Science
    Nuffield College, University of Oxford
    Amsterdam Health and Technology Institute
    Stanford University)

  • Andrea M. Tilstra

    (Leverhulme Centre for Demographic Science
    Nuffield College, University of Oxford
    University of Oxford
    University of Oxford)

  • Mark D. Verhagen

    (Leverhulme Centre for Demographic Science
    Nuffield College, University of Oxford
    Amsterdam Health and Technology Institute
    University of Oxford)

Abstract

The COVID-19 pandemic led to reductions in non-COVID related healthcare use, but little is known whether this burden is shared equally. This study investigates whether reductions in administered care disproportionately affected certain sociodemographic strata, in particular marginalised groups. Using detailed medical claims data from the Dutch universal health care system and rich full population registry data, we predict expected healthcare use based on pre-pandemic trends (2017 – Feb 2020) and compare these expectations with observed healthcare use in 2020 and 2021. Our findings reveal a 10% decline in the number of weekly treated patients in 2020 and a 3% decline in 2021 relative to prior years. These declines are unequally distributed and are more pronounced for individuals below the poverty line, females, older people, and individuals with a migrant background, particularly during the initial wave of COVID-19 hospitalisations and for middle and low urgency procedures. While reductions in non-COVID related healthcare decreased following the initial shock of the pandemic, inequalities persist throughout 2020 and 2021. Our results demonstrate that the pandemic has not only had an unequal toll in terms of the direct health burden of the pandemic, but has also had a differential impact on the use of non-COVID healthcare.

Suggested Citation

  • Arun Frey & Andrea M. Tilstra & Mark D. Verhagen, 2024. "Inequalities in healthcare use during the COVID-19 pandemic," Nature Communications, Nature, vol. 15(1), pages 1-9, December.
    • Handle: RePEc:nat:natcom:v:15:y:2024:i:1:d:10.1038_s41467-024-45720-2
    DOI: 10.1038/s41467-024-45720-2
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    References listed on IDEAS

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    1. Marianne Schoevers & Maartje Loeffen & Maria Muijsenbergh & Antoine Lagro-Janssen, 2010. "Health care utilisation and problems in accessing health care of female undocumented immigrants in the Netherlands," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 55(5), pages 421-428, October.
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