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*, J. Kollmann, T. Magnée, I. Merkelbach, S. Denktaş, P. L. Kocken

*Corresponding author for this work

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1 Citation (Scopus)
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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.

Original languageEnglish
Article number289
JournalBMC Primary Care
Volume23
Issue number1
Early online date19 Nov 2022
DOIs
Publication statusPublished - Dec 2022

Bibliographical note

Funding Information: Funding for our study was provided by ZonMW under grant ID 10430042010058.

Publisher Copyright: © 2022, The Author(s).

Research programs

  • ESSB PSY

Erasmus Sectorplan

  • Sectorplan SSH-Breed

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