Forgone Health Care During the COVID-19 Pandemic

Kakietek, Jakub; Eberwein, Julia Dayton; Kerr, Amanda; Stacey, Nicholas

Forgone Health Care During the COVID-19 Pandemic

Autores

Kakietek, Jakub

Eberwein, Julia Dayton

Kerr, Amanda

Stacey, Nicholas

Editor

Washington, DC: World Bank

Descripción

During the first year of the COVID-19 pandemic, health system disruptions, fear of becoming infected with COVID-19, mobility restrictions and lockdowns, and reduced household incomes likely contributed to households forgoing needed health care. Using repeated measures collected with a standardized instrument over two time periods in 25 countries and roughly 63,000 households, this analysis documents how the prevalence of forgone health care and its drivers changed between the early period of the pandemic in 2020 and the first half of 2021. In 2020, in the pooled sample, 17.9 percent of households reported not being able to obtain needed health care. Reported prevalence of forgone care was 15.6 percent in low-income countries (LICs), 17.0 percent in lower-middle income countries (LMICs), and 20.5 percent in upper-middle-income countries (UMICs) included in the sample. In early 2021, the prevalence of forgone care was lower: 10.3 percent of the households in the pooled sample that reported needing care were not able to obtain it. The prevalence of forgone care was 7.9 percent in LICs, 15.1 percent in LMICs, and 5.3 percent in UMICs. Financial barriers were the main reason households reported for not obtaining needed health care; and among households forgoing care, the share that did so for financial reasons remained similar between the two time periods: 42 percent in 2020 and 45 percent in 2021 (a statistically insignificant change). This study is a comprehensive analysis of the changes in forgone care in low- and middle-income countries. It documents the predominance of financial barriers among those who could not obtain needed health care, especially in low- and lower-middle-income countries as compared to upper-middle-income countries. Given the uneven recovery from the COVID19 pandemic and the deepening economic crisis due to the Russian invasion of Ukraine, it is likely that financial barriers to obtaining health care will persist and perhaps increase, potentially jeopardizing progress toward achieving universal health coverage.