Factors influencing access and utilization of health services among older people during the COVID − 19 pandemic: a scoping review

Abstract

Background Access to healthcare and service utilization are both considered essential factors for improving the general health and wellbeing of older people, especially at the time of COVID-19 pandemic. The aim of the study is to explore factors affecting healthcare access and health service utilization for older people during the pandemic. Methods PubMed, Web of Science, Scopus and Embase were systematically searched for relevant articles. Access, utilization, health, elderly and COVID-19 were used as keywords in the search strategy. A total of 4308 articles were identified through the initial database search; 50 articles were included in the review as passing the eligibility criteria. The searches were conducted up to August 2021. Data extraction was performed, and evidence was descriptively illustrated. Thematic analysis was used to explore factors influencing the elderly’s access and utilization of healthcare services, using Max QDA10, a qualitative analysis software. Results Among articles included in the review (n = 50), a majority of the studies were from the United States (36%), followed by India (8%). According to the main healthcare services, a large number of articles (18%) were related to mental health services, followed by digital health services (16%). Factors were identified at an individual, provider and systems level. Seven main themes emerged from the thematic analysis, as determinants of elderly’s access and utilization of healthcare services during COVID-19 pandemic. These included: access to non-COVID related services, access to COVID-related services, literacy and education, accommodation challenges, perceived attitudes of aging, and policies and structures, and social determinants. Conclusion Mental health and digital health services were identified as major issues influencing or contributing to or influencing older people’s health during the COVID-19 pandemic. We also argue on the importance of a rounded view, as attention to a range of factors is vital for policy decisions towards sustainable care and equitable interventions for improving the health of older people.

Socioeconomic Disparities in the Demand for and Use of Virtual Visits Among Senior Adults During the COVID-19 Pandemic: Cross-sectional Study

“…Age-related health factors, such as multimorbidity and limitations on functional capacity, make routine as well as urgent health care critical for the well-being of older adults. Older adults may experience challenges with accessing health services due to physical capacity limitations, financial barriers, and deteriorating psychological conditions [ 7 ]. The COVID-19 pandemic posed additional challenges for older adults, such as misinformation, physical and psychological isolation, and limitations to routine activities [ 8 ].…”

System, institutional, and client-level factors associated with formal healthcare utilisation among older adults with low income under a social protection scheme in Ghana

“…Considerable literature has emerged describing demographic, biological, and socioeconomic factors that contribute to health services uptake among older adults [ 11 , 17 ]. Older adults with better economic conditions tend to access and utilize health services easily and more desirably [ 17 , 18 ]. This evidence suggests existential barriers to access and use of health services needed by older people with lower socioeconomic status.…”

Acceptance of Social Networking Sites by Older People before and after COVID-19 Confinement: A Repeated Cross-Sectional Study in Chile, Using the Theory of Planned Behaviour (TPB)

“…In addition to socioeconomic barriers, other variables that influenced the use of these technologies in older people during confinement were access to the Internet and previous use of video calls [ 29 ], level of education, digital literacy, and attitudes toward oneself aging [ 30 , 32 , 33 ]. According to international research, the benefits obtained were related to improvements in mental health, decreased loneliness, strengthening of physical capacity, mood, and memory enhancements [ 34 , 35 ].…”