People who avoided the doctor had a two times higher risk of death during the corona pandemic than their peers who did go to the doctor
Vulnerable people over the age of seventy who avoided care during the corona pandemic died more often than people who did go to the doctor. These elderly people suffered more from anxiety and depression than their peers. In particular, these complaints in combination with their view of their own health play an important role in mortality. This is evident from a study by Erasmus MC.
‘The relationship between care avoidance and mortality that we investigated seemed so logical,’ says PhD student Marije Splinter from the Epidemiology department of Erasmus MC. And there is also that relationship: people who avoided the doctor had a twice higher risk of death during the corona pandemic than their peers who did go to the doctor.
But when unraveling the relationship between care avoidance and mortality, it turned out that low mental and physical self-esteem of their health played a role. Splinter and her colleagues published this in the British journal for general practice, British Journal of General Practice. ‘These vulnerable elderly people who avoided care were more likely to suffer from anxiety and depression than their peers who did visit the doctor. They also considered themselves to be in fair or poor health.’
Contradictory
The findings reveal that the relationship between care avoidance and mortality is less strong than the researchers initially suspected. ‘We thought that canceling or postponing a doctor’s visit would play an important role in mortality. But if we zoom in on elderly people with anxiety and depression, the relationship between care avoidance and mortality disappears,” according to Splinter.
The question remains whether these elderly people would not have died if they had visited the doctor. “It is a contradictory phenomenon that vulnerable people who need care the most receive it less often,” adds epidemiologist and GP in training Silvan Licher.
Accessibility
In his daily work in general practice, Licher recognizes what he sees in the study. ‘Every GP knows patients in his or her practice who are medically vulnerable and have limited resources or knowledge that affect their access to care. This group came under extra pressure during the pandemic. Especially when general practitioners limited their consultation hours to provide more care to corona patients. This study teaches us that we must continue to pay attention to this vulnerable group of patients, especially in times of crises.’
The researchers emphasized mortality after previous research. During the first national press conferences it was said: only go to the doctor if it is really necessary. ‘That will have to be different next time. Because not everyone can make that assessment correctly and not all medical complaints are always clear. Now we know better: keeping healthcare open is important, but that does not prevent healthcare avoidance. It is a structural, social problem that has been magnified during the pandemic,” Splinter concludes.
ERGO
For this study, the researchers used the Erasmus Rotterdam Health Research (ERGO) study, also known as the Rotterdam Study, in Ombloed. Of the 5656 participants who answered the questionnaire about their medical complaints during the pandemic, 1143 indicated that they had not sought care despite their experienced symptoms. A total of 293 participants died before January 1, 2023. In the vulnerable group, 93 participants died, 2 times more than the group that did not avoid care.
Source: Erasmus MC
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