• Lakshmi Krishna Menon, Viviane Richard, Carlos de Mestral, Hélène Baysson, Ania Wisniak, Idris Guessous, Silvia Stringhini, and Specchio-COVID19 Study Group.
• Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Rue Jean-Violette 29, 1205 Genève, Switzerland; Institute of Global Health, University of Geneva, Chemin des Mines 9, 1202 Genève, Switzerland. Electronic address: lakshmi.menon@etu.unige.ch.
• Prev Med. 2022 Mar 1; 156: 106987106987.

BackgroundHealth systems around the world continue to navigate through operational challenges surfaced by the coronavirus disease 2019 (COVID-19) pandemic; these have implications for access to healthcare. In this study, we estimate the prevalence and reasons for forgoing healthcare during the pandemic in Geneva, Switzerland; a country with a universal and mandatory private health insurance coverage.MethodsParticipants from a randomly selected population-based sample of the adult population living in the Canton of Geneva completed an online socio-demographic and lifestyle questionnaire between November 2020 and January 2021. The prevalence and reasons for forgoing healthcare since the beginning of the COVID-19 pandemic were examined descriptively, and logistic regression models were used to assess determinants for forgoing healthcare.ResultsThe study included 5397 participants, among which 8.0% reported having forgone healthcare since the beginning of the COVID-19 pandemic; participants with a disadvantaged financial situation (OR = 2.04; 95% CI: 1.56-2.65), and those reporting an average (OR = 2.54; 95% CI: 1.94-3.31) or poor health (OR = 4.40; 95% CI: 2.39-7.67) were more likely to forgo healthcare. The most common reasons to forgo healthcare were appointment cancellations by healthcare providers (53.9%), fear of infection (35.3%), and personal organizational issues (11.1%).ConclusionOur paper highlights the effects of the COVID-19 pandemic on access to healthcare and identifies population sub-groups at-risk for forgoing healthcare. These results necessitate public health efforts to ensure equitable and accessible healthcare as the COVID-19 pandemic continues.Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.

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