Self-perceived barriers to healthcare access for patients with post COVID-19 condition

BACKGROUND: Many patients with post COVID-19 condition (PCC) require healthcare services. However, qualitative studies indicate that patients with PCC encounter many barriers to healthcare access. This cross-sectional study aimed to identify which barriers to healthcare access patients report, and to determine differences between subgroups based on sociodemographic characteristics, medical characteristics, and PCC symptoms (fatigue, dyspnoea, cognitive problems, anxiety and depression). METHODS: Data were collected via an online survey from 10,462 adult patients with a confirmed or suspected COVID-19 infection in the Netherlands, who experienced persisting symptoms ≥3 months after the initial infection. To measure self-perceived barriers, a list of eleven possible barriers was used, covering multiple aspects of healthcare access. RESULTS: Respondents reported a median of 2.0 (IQR=3.0) barriers; “I didn’t know who to turn to for help” (50.9%) and “No one with the right knowledge/skills was available” (36.8%) were most frequently reported. Multivariate logistic regression analyses showed that those with lower age, higher educational level, longer disease duration, not hospitalized, and who had more severe PCC symptoms, had significantly higher odds of reporting ≥1 barrier to healthcare access. Analyses per barrier showed that women had higher odds of reporting financial barriers as well as feeling uncomfortable asking for help, while men had higher odds of reporting barriers related to availability of care. Hospitalized respondents had lower odds of reporting barriers related to availability of care, but not financial barriers. CONCLUSIONS: This study shows that the majority of patients with PCC experiences barriers to healthcare access and that the type of barriers patients experience differs depending on sociodemographic and medical characteristics. Differences by educational level might be due to underrepresentation of low educated patients who experience barriers. KEY MESSAGES: • Many patients with post COVID-19 condition experience barriers to healthcare access, including barriers related to availability of care, finances, and feeling uncomfortable asking for help. • The number and type of barriers patients with post COVID-19 condition report differs depending on sociodemographic characteristics, medical characteristics and the presence of core symptoms.