Stroke but no hospital admission: Lost opportunity for whom?

Carine Milcent (), Hanta Ramaroson, Fleur Maury, Florence Binder-Foucard, Marie Moitry and Anne-Marie Moulin
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Carine Milcent: PSE - Paris School of Economics - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris Sciences et Lettres - EHESS - École des hautes études en sciences sociales - ENPC - École nationale des ponts et chaussées - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, PJSE - Paris Jourdan Sciences Economiques - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris Sciences et Lettres - EHESS - École des hautes études en sciences sociales - ENPC - École nationale des ponts et chaussées - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement
Hanta Ramaroson: Bordeaux University Hospital
Fleur Maury: Lille University Hospital, Medical Information Department
Florence Binder-Foucard: HUS - Les Hôpitaux Universitaires de Strasbourg
Marie Moitry: UNISTRA - Université de Strasbourg
Anne-Marie Moulin: SPHERE UMR 7219 - Sciences, Philosophie, Histoire - CNRS - Centre National de la Recherche Scientifique - UPCité - Université Paris Cité

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Abstract: To counter the spread of COVID-19, the French government imposed several stringent social and political measures across its entire population. We hereto assess the impact of these political decisions on healthcare access in 2020, focusing on patients who suffered from an ischemic stroke. We divide our analysis into four distinct periods: the pre-COVID-19 pandemic period, the lockdown period, the "in-between" or transitional period, and the shutdown period. Our methodology involves utilizing a retrospective dataset spanning 2019–2020, an exhaustive French national hospital discharge diagnosis database for stroke inpatients, integrated with income information from the reference year of 2019. The results reveal that the most affluent were more likely to forgo medical care, particularly in heavily affected areas. Moreover, the most disadvantaged exhibited even greater reluctance to seek care, especially in the most severely impacted regions. The data suggest a loss of opportunity for less severely affected patients to benefit from healthcares during this lockdown period, regardless of demographic, location, and socioeconomic determinants. Furthermore, our analysis reveals a notable discrepancy in healthcare-seeking behavior, with less affluent patients and seniors (over 75 years old) experiencing slower rates of return to healthcare access compared to pre-pandemic levels. This highlights a persistent gap in healthcare accessibility, particularly among socioeconomically disadvantaged groups, despite the easing of COVID-19 restrictions.

Keywords: Deprivation; Geographical residence; Inequity; COVID-19 pandemic; Healthcare access; Public health; Stroke (search for similar items in EconPapers)
Date: 2024
New Economics Papers: this item is included in nep-hea
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Published in PLoS ONE, 2024, 19 (8), ⟨10.1371/journal.pone.0307220⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-04690280

DOI: 10.1371/journal.pone.0307220

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