Association between perception of COVID-19 risk, confidence in health services and avoidance of emergency department visits: results from a community-based survey in Portugal. Issue 7 (8th July 2022)

• Record Type: Journal Article
• Authors: Lopes, Sílvia; Soares, Patrícia; Gama, Ana; Pedro, Ana Rita; Moniz, Marta; Laires, Pedro; Goes, Ana Rita; Nunes, Carla; Dias, Sónia
• Is Part Of: BMJ open. Volume 12:Issue 7(2022)
• Publication Date: 2022-07-08
• Subjects: COVID-19 -- health policy -- accident & emergency medicine; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2021-058600
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: To examine the association between the perception of COVID-19 risk, confidence in health services and avoidance of emergency department (ED) visits in Portugal during the COVID-19 pandemic. Design: Community-based, cross-sectional survey. Setting: Volunteer sample that completed the online survey between April 2020 and May 2021. Participants: 987 participants who perceived needing ED care. Of those, 242 reported avoiding ED visits. Outcome measures: Logistic regression models for ED avoidance were conducted to estimate the effect of risk perception and confidence in health services, adjusted for sociodemographics, health status and time. Results: The adjusted odds for ED avoidance were higher for participants lacking confidence in health service response to non-COVID-19 conditions (adjusted OR: 6.39; 95% CI 3.19 to 12.82) and COVID-19 (1.81; 1.19 to 2.77) and lower for those perceiving a low risk of being infected at a health provider (0.16; 0.07 to 0.38). Conclusion: In our sample, confidence in health services and risk perception of infection at a health provider were associated with the decision to avoid the ED. These results suggest that policymakers and care providers need to mitigate the negative consequences of delayed healthcare; be aware of the implications of distrust and fear from those in need of healthcare and provide equally distributed safe alternatives to ED care.