Intended health care utilisation in cases of severe COVID-19 and inflammatory gastrointestinal disease – results of a population survey with vignettes

TY - JOUR

T1 - Intended health care utilisation in cases of severe COVID-19 and inflammatory gastrointestinal disease – results of a population survey with vignettes

AU - Klein, Jens

AU - Strauß, Annette

AU - Koens, Sarah

AU - Schäfer, Ingmar

AU - von dem Knesebeck, Olaf

PY - 2022/3/31

Y1 - 2022/3/31

N2 - Objectives To examine variations in intended healthcare utilisation in severe cases of COVID-19 and inflammatory gastrointestinal disease (IGD).Design Representative cross-sectional telephone survey.Setting and participants 1207 randomly drawn adults of the city of Hamburg, Germany, between November 2020 and January 2021.Outcome measures Different vignettes with severe symptoms were presented varying in sex, age (child, middle-aged person, older person), daytime (Tuesday morning or Tuesday evening) and disease (COVID-19 or IGD), while the degree of urgency was equivalent for all cases. The respondents were asked for the intended healthcare utilisation resulting in three different alternatives: general practitioner (GP)/paediatrician, medical on-call service (‘116117’) and emergency care (accident and emergency department, emergency practice, rescue service). In multivariate analyses, associations of characteristics of the vignettes and participants (sex, age, education, migration background) with intended healthcare utilisation were tested. In a further step, analyses were conducted separately for IGD and COVID-19.Results Regarding the vignettes’ characteristics, intended utilisation of GP/paediatrician is associated with female sex, higher age, daytime (morning) and COVID-19 symptoms, the medical on-call service with male sex, daytime (evening) and COVID-19 symptoms and the emergency medicine with younger age, daytime (evening) and IGD. Women chose more often the GP/paediatrician, men preferred emergency medicine. Only in case of IGD, higher educated persons more often chose the medical on-call service while people with a migration background decided less often for medical on-call service and emergency medicine.Conclusions Despite comparable urgency, the findings suggest variations of intended healthcare utilisation depending on various characteristics of the vignettes and respondents. Depending on the type of disease inequalities vary. Overall, information about healthcare alternatives in severe cases has to be improved and clear pathways to facilitate healthcare utilisation has to be further developed.

AB - Objectives To examine variations in intended healthcare utilisation in severe cases of COVID-19 and inflammatory gastrointestinal disease (IGD).Design Representative cross-sectional telephone survey.Setting and participants 1207 randomly drawn adults of the city of Hamburg, Germany, between November 2020 and January 2021.Outcome measures Different vignettes with severe symptoms were presented varying in sex, age (child, middle-aged person, older person), daytime (Tuesday morning or Tuesday evening) and disease (COVID-19 or IGD), while the degree of urgency was equivalent for all cases. The respondents were asked for the intended healthcare utilisation resulting in three different alternatives: general practitioner (GP)/paediatrician, medical on-call service (‘116117’) and emergency care (accident and emergency department, emergency practice, rescue service). In multivariate analyses, associations of characteristics of the vignettes and participants (sex, age, education, migration background) with intended healthcare utilisation were tested. In a further step, analyses were conducted separately for IGD and COVID-19.Results Regarding the vignettes’ characteristics, intended utilisation of GP/paediatrician is associated with female sex, higher age, daytime (morning) and COVID-19 symptoms, the medical on-call service with male sex, daytime (evening) and COVID-19 symptoms and the emergency medicine with younger age, daytime (evening) and IGD. Women chose more often the GP/paediatrician, men preferred emergency medicine. Only in case of IGD, higher educated persons more often chose the medical on-call service while people with a migration background decided less often for medical on-call service and emergency medicine.Conclusions Despite comparable urgency, the findings suggest variations of intended healthcare utilisation depending on various characteristics of the vignettes and respondents. Depending on the type of disease inequalities vary. Overall, information about healthcare alternatives in severe cases has to be improved and clear pathways to facilitate healthcare utilisation has to be further developed.

U2 - 10.1136/bmjopen-2021-057644

DO - 10.1136/bmjopen-2021-057644

M3 - SCORING: Journal article

C2 - 35361649

VL - 12

SP - e057644

JO - BMJ OPEN

JF - BMJ OPEN

SN - 2044-6055

IS - 3

M1 - e057644

ER -