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. 2022 Nov 19;23(1):289.
doi: 10.1186/s12875-022-01887-5.

The role of socio-demographic and health factors during COVID-19 in remote access to GP care in low-income neighbourhoods: a cross-sectional survey of GP patients

S Sana  1 , J Kollmann  2 , T Magnée  2   3 , I Merkelbach  2 , S Denktaş  2 , P L Kocken  2
Affiliations

The role of socio-demographic and health factors during COVID-19 in remote access to GP care in low-income neighbourhoods: a cross-sectional survey of GP patients

S Sana et al. BMC Prim Care. .

Abstract

Objectives: Remote consultations were common in general practice during the COVID-19 pandemic. This approach may have affected access to GP care for people with low socio-economic status: this group has a high prevalence of chronic conditions and a higher mortality rate due to COVID-19. This study explores the association of sociodemographic and health factors with the decision to contact a GP practice, and care utilisation, among patients in low-income neighbourhoods in the Netherlands.

Design: Cross-sectional survey study.

Setting: General practice in low-income neighbourhoods in the Netherlands.

Participants: Patients from low-income neighbourhoods were selected from fourteen general practices on the basis of ethnic background, chronic disease or health literacy. Participants were stratified according to categories of these background characteristics to obtain equal numbers per category. A total of 213 surveys were retained for analysis.

Main outcome measures: Need for GP contact, decision to contact a GP practice, and GP service utilisation.

Results: Forty-five percent (N = 88) of the participants experienced health problems for which they wished to consult their GP at the start of the outbreak of COVID-19. A majority of them (81%) had contact with a GP service. The need to contact the GP was significantly associated with financial difficulties (OR 2.20 CI (1.10 to 4.39)). An interaction effect was found of health literacy with concerns about COVID-19 with in respondents with low health literacy a significant association between concerns about COVID-19 and a need for a GP appointment (OR 5.33 CI (2.09 to 13.59)) and absence of a significant association in the higher health literacy group (OR 1.14 CI (0.51 to 2.56)) . Moreover, 56% (N = 74) of the participants received remote care at least one time during the first wave of COVID-19. Female participants used remote care more often (OR 3.22 CI (1.57 to 6.59)) and participants aged 50 and over used remote care less often (OR 0.46 CI (0.21 to 0.97)).

Conclusion: Many patients in low-income neighbourhoods were able to consult a GP, often remotely. However from the equity perspective, access to GP care should be safeguarded for patients with health problems, financial difficulties and low health literacy because of their greater need to consult a GP during times of crisis.

Keywords: Access; COVID-19; Care use; General practice; Healthcare disparities; Low-income population; Primary health care.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Conceptual model of GP service access
Fig. 2
Fig. 2
Proportion of respondents needing and utilizing GP care
See this image and copyright information in PMC

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References

    1. Eberly LA, Kallan MJ, Julien HM, Haynes N, Khatana SAM, Nathan AS, et al. Patient characteristics associated with telemedicine access for primary and specialty ambulatory care during the COVID-19 pandemic. JAMA Netw Open. 2020;3:e2031640. doi: 10.1001/jamanetworkopen.2020.31640. - DOI - PMC - PubMed
    1. Mein SA. COVID-19 and health disparities: the reality of "the great equalizer". J Gen Intern Med. 2020;35:2439–2440. doi: 10.1007/s11606-020-05880-5. - DOI - PMC - PubMed
    1. Imlach F, McKinlay E, Middleton L, Kennedy J, Pledger M, Russell L, et al. Telehealth consultations in general practice during a pandemic lockdown: survey and interviews on patient experiences and preferences. BMC Fam Pract. 2020;21:1–14. doi: 10.1186/s12875-020-01336-1. - DOI - PMC - PubMed
    1. Knights F, Carter J, Deal A, Crawshaw AF, Hayward SE, Jones L, et al. Impact of COVID-19 on migrants’ access to primary care and implications for vaccine roll-out: a national qualitative study. Br J Gen Pract. 2021;71:e583–e595. doi: 10.3399/BJGP.2021.0028. - DOI - PMC - PubMed
    1. Mann DM, Chen J, Chunara R, Testa PA, Nov O. COVID-19 transforms health care through telemedicine: evidence from the field. J Am Med Inform Assoc. 2020;27:1132–1135. doi: 10.3399/BJGP.2021.0028. - DOI - PMC - PubMed

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