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Prevalence and factors associated with non-use of health services in the Peruvian population with COVID-19 symptomatology: a secondary analysis of the 2020 National Household Survey
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Akram Hernández-Vásquez, Fabriccio J. Visconti-Lopez, Diego Azañedo
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Epidemiol Health. 2021;43:e2021084. Published online October 18, 2021
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DOI: https://doi.org/10.4178/epih.e2021084
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Abstract
OBJECTIVES
The objective of this study was to estimate the prevalence of non-use of health services (NUHS) and its associated factors in Peruvians with symptoms of coronavirus disease 2019 (COVID-19).
METHODS A secondary analysis of the 2020 National Household Survey (ENAHO) was carried out. Participants over 18 years of age with any COVID-19 symptom (fever, cough, sensation of shortness of breath) in the last 4 weeks who did not visit health services were defined as exhibiting NUHS. Adjusted prevalence ratios (aPRs) were estimated to determine the factors associated with NUHS.
RESULTS Data from 1,856 participants were analyzed; the prevalence of NUHS was 52.2% (95% confidence interval [CI], 48.0 to 56.5). Living in urban areas of the jungle (aPR, 1.61; 95% CI, 1.32 to 1.98; p<0.001) and rural areas of the jungle (aPR, 1.48; 95% CI, 1.15 to 1.90; p=0.002) was associated with a higher probability of NUHS than living in urban coastal areas. The factors associated with a lower probability of NUHS were being 50-59 years old (aPR, 0.72; 95% CI, 0.58 to 0.90) and 60 years and over (aPR, 0.74; 95% CI, 0.59 to 0.95), having a secondary educational level (aPR, 0.67; 95% CI, 0.48 to 0.93) or superior educational level (aPR, 0.67; 95% CI, 0.48 to 0.96), and having health insurance (aPR, 0.79; 95% CI, 0.68 to 0.92).
CONCLUSIONS More than half of the participants with COVID-19 symptoms did not use health services, and NUHS was associated with the geographic and socio-demographic characteristics of the population. The formulation of health strategies and programs is required to increase the use of health services by people with COVID-19 symptoms.
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Summary
Key Message
The objective of this study was to estimate the prevalence of non-use of health services (NUHS) and its associated factors in Peruvians with symptoms of coronavirus disease 2019 (COVID-19) in 2020. In the study, more than half of the participants with COVID-19 symptoms did not use health services, and NUHS was associated with the geographic and socio-demographic characteristics of the population. The formulation of health strategies and programs is required to increase the use of health services by people with COVID-19 symptoms, in the country with the highest mortality rate by this disease.
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Citations
Citations to this article as recorded by  - Staying in or out? COVID-19-induced healthcare utilization avoidance and associated socio-demographic factors in rural India
Michael Safo Oduro, Prince Peprah, Anthony Kwame Morgan, Williams Agyemang-Duah
BMC Public Health.2023;[Epub] CrossRef - Chronic disease relapses: A cross-sectional study of the associated factors and socioeconomic inequalities during the COVID-19 pandemic in Peru
Fabriccio J. Visconti-Lopez, Akram Hernández-Vásquez, Dustin M. Solorzano-Salazar, Diego Azañedo, Ramune Jacobsen
PLOS ONE.2022; 17(9): e0274697. CrossRef - COVID-19 and drivers of excess death rate in Peru: A longitudinal ecological study
Kim N. Cajachagua-Torres, Hugo G. Quezada-Pinedo, Carlos A. Huayanay-Espinoza, Jordan A. Obeso-Manrique, Víctor A. Peña-Rodríguez, Elisa Vidal, Luis Huicho
Heliyon.2022; 8(12): e11948. CrossRef
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Associations between chronic conditions and oral health services utilization in older Peruvian adults: a pooled analysis of the Demographic and Health Survey 2015-2017
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Diego Azañedo, Diego Chambergo-Michilot, Akram Hernández-Vásquez
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Epidemiol Health. 2020;42:e2020023. Published online April 9, 2020
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DOI: https://doi.org/10.4178/epih.e2020023
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Abstract
OBJECTIVES
This study was conducted to investigate the associations between chronic conditions (CCs) and oral health services utilization (OHSU) within the previous 6 months in older Peruvian adults (defined as those 60 years of age or more according to Peruvian law).
METHODS An analytical cross-sectional study was performed based on the 2015-2017 Peruvian Demographic and Family Health Survey. Pooled data from 13,699 older adults were analyzed. A logistic regression model was used to analyze the associations between OHSU (dependent variable) and CCs (independent variables). Tobacco consumption, obesity, educational level, age, sex, welfare quintile, area of residence, having health insurance, and natural region of residence were included as covariates in the analysis.
RESULTS The frequency of OHSU in older adults was 18.5% (95% confidence interval [CI], 17.8 to 19.3). The highest percentage point (%p) differences with regards to OHSU were found between the extreme categories of educational level (higher education vs. none or elementary school: +24.8%p) and welfare quintile (richest vs. poorest: +24.0%p). In the crude model, OHSU was associated with diabetes (odds ratio [OR], 1.46; 95% CI, 1.26 to 1.69), but this association disappeared after adjustment for covariates. Meanwhile, depression decreased the likelihood of OHSU (OR, 0.82; 95% CI, 0.72 to 0.95) in the adjusted model.
CONCLUSIONS The frequency of OHSU was low in older Peruvian adults. Regarding CCs, we found that depression independently decreased the likelihood of OHSU in the adjusted model. Our results may be useful for the development of policies aimed at achieving greater OHSU in older adults with CCs, especially in those with depression.
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