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Prevalence and factors associated with non-use of health services in the Peruvian population with COVID-19 symptomatology: a secondary analysis of the 2020 National Household Survey

A. Hernández-Vásquez, Fabriccio J. Visconti-Lopez, Diego Azañedo

Epidemiology and Health, 2021

1,856 participants · 406 citations

Abstract

OBJECTIVES The objective of this study was to estimate the prevalence of non-use of health services (NUHS) and its associated factors in Peruvians with symptoms of coronavirus disease 2019 (COVID-19). METHODS A secondary analysis of the 2020 National Household Survey (ENAHO) was carried out. Participants over 18 years of age with any COVID-19 symptom (fever, cough, sensation of shortness of breath) in the last 4 weeks who did not visit health services were defined as exhibiting NUHS. Adjusted prevalence ratios (aPRs) were estimated to determine the factors associated with NUHS. RESULTS Data from 1,856 participants were analyzed; the prevalence of NUHS was 52.2% (95% confidence interval [CI], 48.0 to 56.5). Living in urban areas of the jungle (aPR, 1.61; 95% CI, 1.32 to 1.98; p<0.001) and rural areas of the jungle (aPR, 1.48; 95% CI, 1.15 to 1.90; p=0.002) was associated with a higher probability of NUHS than living in urban coastal areas. The factors associated with a lower probability of NUHS were being 50-59 years old (aPR, 0.72; 95% CI, 0.58 to 0.90) and 60 years and over (aPR, 0.74; 95% CI, 0.59 to 0.95), having a secondary educational level (aPR, 0.67; 95% CI, 0.48 to 0.93) or superior educational level (aPR, 0.67; 95% CI, 0.48 to 0.96), and having health insurance (aPR, 0.79; 95% CI, 0.68 to 0.92). CONCLUSIONS More than half of the participants with COVID-19 symptoms did not use health services, and NUHS was associated with the geographic and socio-demographic…

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