Reduced access to care among older American adults during CoVID-19 pandemic: results from a prospective cohort study

Background: Due to preexisting conditions, older adults are at higher risk of COVID-19 related severe complications. Current evidence is limited on access to care for older adults during the COVID-19 pandemic. Objectives: To examine the extent of reduced access to care among older American adults during the COVID-19 pandemic, identify predictors and reasons of reduced access. Materials and methods: Using publicly available data from the COVID-19 module of the Health and Retirement Study, we undertook descriptive analyses of older adults stratified by sex, age group, race, education, marital status, employment, receipt of social security benefits, health insurance, number of limitations in activities of daily living and pre-existing conditions. Associations between reduced access to care and predictors were estimated using a multivariable logistic regression model. Results: About 30 per cent of respondents delayed or avoided care during the pandemic. Reduced access was more likely to be reported by respondents that were female, younger, educated, not receiving social security benefits, with limitations in daily activities and three preexisting conditions. In terms of the reasons, the majority of the respondents reported that their visit was either cancelled or rescheduled by the provider; 13.9 per cent thought they could wait, 10.9 per cent could not get an appointment, 9.1 per cent found it unaffordable, and 7.4 per cent were afraid to visit the provider. Respondents reported of reduced access to doctor visits, surgery, prescription filling, and dental care. Conclusions: We suggest urgent attention on improving access to care for older adults during the pandemic. For nonemergency conditions and routine care that can be delivered virtually, telehealth services can be strengthened. Additionally, health messaging can reemphasize that neglecting medical care might lead to increased morbidity and mortality among older adults from preexisting illnesses.