COVID-19 and outpatient care: a nationwide household survey

We aimed to assess the proportion of the population in 133 Brazilian municipalities who - from March to August 2020 - had a health problem but failed to seek care or failed to attend to a health service for routine appointment or examination. We conducted a household survey from August 24-27 in 133 Brazilian cities by asking the subjects if since the beginning of the COVID-19 pandemic in March 2020, they had suffered from a health problem but did not seek care or failed to attend to a routine or screening examination. Poisson regression was used for the analyses. We interviewed 33,250 subjects and 11.8% (95%CI: 11.4-121) reported that, since March 2020, they failed to seek care despite being ill, 17.3% (95%CI: 16.9- 17.7) failed to attend to a routine or screening examination and 23.9% (95%CI: 23.4-24.4) reported one or both outcomes. Health service closure and fear of the COVID-19 infection were the main reasons for not seeking care. Women and the poorest were more likely to not look for a health service, despite having a health problem or a scheduled routine appointment. On the other hand, those subjects who self-identified as white were less likely to not look for a health service. The COVID-19 pandemic is more critical for the indigenous people and the poorest, and these people are also more likely to not seek care for other health conditions during the pandemic.

Automated summary

The study aimed to assess the proportion of the population in 133 Brazilian municipalities who did not seek care or attend health services for health problems during the COVID-19 pandemic. The findings showed that 11.8% of the participants did not seek care despite being ill, 17.3% failed to attend routine or screening examinations, and 23.9% reported one or both outcomes. Health service closure and fear of COVID-19 infection were the main reasons for not seeking care. Women and the poorest individuals were more likely to not seek healthcare, while those who self-identified as white were less likely to do so. The study highlights the critical impact of the pandemic on indigenous populations and the poorest, who are also less likely to seek care for other health conditions.