Use of health care services among people with Covid-19 symptoms in the first pandemic peak in France

Jeanna-Eve Pousson, Léna Silberzan, Florence Jusot, Laurence Meyer, Josiane Warszawski and Nathalie Bajos ()
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Jeanna-Eve Pousson: IRIS - Institut de Recherche Interdisciplinaire sur les enjeux Sociaux - sciences sociales, politique, santé - EHESS - École des hautes études en sciences sociales - INSERM - Institut National de la Santé et de la Recherche Médicale - CNRS - Centre National de la Recherche Scientifique - Université Sorbonne Paris Nord
Léna Silberzan: IRIS - Institut de Recherche Interdisciplinaire sur les enjeux Sociaux - sciences sociales, politique, santé - EHESS - École des hautes études en sciences sociales - INSERM - Institut National de la Santé et de la Recherche Médicale - CNRS - Centre National de la Recherche Scientifique - Université Sorbonne Paris Nord
Florence Jusot: Université Paris Dauphine-PSL - PSL - Université Paris Sciences et Lettres, LEDa - Laboratoire d'Economie de Dauphine - IRD - Institut de Recherche pour le Développement - Université Paris Dauphine-PSL - PSL - Université Paris Sciences et Lettres - CNRS - Centre National de la Recherche Scientifique
Laurence Meyer: CESP - Centre de recherche en épidémiologie et santé des populations - UVSQ - Université de Versailles Saint-Quentin-en-Yvelines - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Paul Brousse - INSERM - Institut National de la Santé et de la Recherche Médicale - Université Paris-Saclay
Josiane Warszawski: CESP - Centre de recherche en épidémiologie et santé des populations - UVSQ - Université de Versailles Saint-Quentin-en-Yvelines - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Paul Brousse - INSERM - Institut National de la Santé et de la Recherche Médicale - Université Paris-Saclay
Nathalie Bajos: IRIS - Institut de Recherche Interdisciplinaire sur les enjeux Sociaux - sciences sociales, politique, santé - EHESS - École des hautes études en sciences sociales - INSERM - Institut National de la Santé et de la Recherche Médicale - CNRS - Centre National de la Recherche Scientifique - Université Sorbonne Paris Nord, EHESS - École des hautes études en sciences sociales

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Abstract: In France, the first pandemic peak fell disproportionately on the most disadvantaged, as they were overrepresented in contaminations and in developing severe forms of the virus. At that time, and especially during lockdown, the French healthcare system was severely disrupted and limited. The issue of social differences in the use of healthcare by people experiencing symptoms of Covid-19 arose. Based on a random sample of 135,000 persons, we selected respondents who reported Covid-19-like symptoms (cough, fever, dyspnea, anosmia and/or ageusia) during the first lockdown (n = 12,422). The aim of this study was to determine if the use of health care services was likely to contribute to widen Covid-19 social inequalities. Use of health care services was classified in three categories: (1) no consultation, (2) out-of-hospital consultation(s) and (3) in-hospital consultation(s). We estimated odds ratio of utilization of health care using multinomial regressions, adjusted on social factors (age, gender, class, ethno-racial status, social class, standard of living and education), contextual variables, health variables, and symptoms characteristics. Altogether, 37.8% of the individuals consulted a doctor for their symptoms; 32.1% outside hospital and 5.7% in hospital. Use of health care services was strongly associated with social position2: the most disadvantaged social groups and racially minoritized immigrants were more likely to use health care, particularly for in-hospital consultation(s). The highest utilization of health care were found among older adults (OR 9.51, 95%CI 5.02–18.0 compared to the youngest age group), the racially minoritized first-generation immigrants (OR 1.61, 95%CI 1.09–2.36 compared to the mainstream population), the poorest (OR 1.31, 95%CI 1.00–1.72) and the least educated (OR 2.20, 95%CI 1.44–3.38). To conclude, we found that the use of health care services counteracted the potential impact of social inequalities in exposure and infection to the Covid-19.

Date: 2022
Note: View the original document on HAL open archive server: https://hal.science/hal-05006500v1
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Published in PLoS ONE, 2022, 17 (12), pp.e0279538. ⟨10.1371/journal.pone.0279538⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-05006500

DOI: 10.1371/journal.pone.0279538

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