A cross-sectional study of the relationship between delayed healthcare utilisation and chronic conditions among older adults during the COVID-19 pandemic in Ireland

Abstract

Background: Many healthcare services were cancelled or postponed during the coronavirus 2019 (COVID-19) pandemic, likely impacting the management of chronic conditions prevalent among older adults in Ireland. Methods: Data from the Irish Longitudinal Study on Ageing COVID-19 study and previous waves were used. Taking healthcare demand into account, the relationship between delayed healthcare utilisation among older adults (≥50) with chronic conditions was examined. Further analyses examined the reasons for delays in healthcare utilisation, and whether they were the result of the reduced availability of healthcare services or participant decisions. Results: In total, 31.6% of participants reported experiencing healthcare delay. The first analysis found that older adults with two or more chronic conditions were more likely to have experienced healthcare delay than those with no chronic conditions (odds ratio (OR): 1.46, 95% confidence interval (CI): 1.11, 1.90). The second analysis found that older adults with two or more chronic conditions were more likely to have healthcare delayed by the provider (OR: 1.73, 95% CI: 1.16, 2.56), and were also more likely to delay their own healthcare (OR: 1.62, 95% CI: 1.14, 2.29) than older adults with no chronic conditions. Additionally, people aged 70 years and over, females, those with problematic alcohol consumption, those with third-level education, those who had visited the GP and those who reported polypharmacy were all more likely to experience healthcare delay, while older adults living with others and those living outside Dublin were less likely to experience healthcare delay. Conclusion: COVID-19 has had a significant impact on the healthcare utilisation of older adults in Ireland, with some groups of older adults impacted more than others. Policy and practice must now focus on how the healthcare needs of these groups can be best served. Further research is required to understand the impact of healthcare delays on health outcomes.