Seeking Healthcare During Lockdown: Challenges, Opportunities and Lessons for the Future

Document Type : Original Article

Authors

1 Health Services Research Centre, Victoria University of Wellington, Wellington, New Zealand

2 Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand

3 School of Nursing, Midwifery and Health Practice, Victoria University of Wellington, Wellington, New Zealand

Abstract

Background 
In Aotearoa/New Zealand, the first nation-wide coronavirus disease 2019 (COVID-19) lockdown occurred from March 23, 2020 to May 13, 2020, requiring most people to stay at home. Health services had to suddenly change how they delivered healthcare and some services were limited or postponed. This study investigated access to healthcare during this lockdown period, whether patients delayed seeking healthcare and reasons for these delays, focusing on the accessibility of primary care services.
 
Methods 
Adults (aged 18 years or older) who had contact with primary care services were invited through social media and email lists to participate in an online survey (n = 1010) and 38 people were recruited for in-depth interviews. We thematically analysed qualitative data from the survey and interviews, reported alongside relevant descriptive survey results.
 
Results 
More than half (55%) of survey respondents delayed seeking healthcare during lockdown. Factors at a national or health system-level that could influence delay were changing public service messages, an excessive focus on COVID-19 and urgent issues, and poor service integration. Influential factors at a primary care-level were communication and outreach, use of technology, gatekeeping, staff manner and the safety of the clinical practice environment. Factors that influenced patients’ individual decisions to seek healthcare were the ability to self-manage and self-triage, consciousness of perceived pressure on health services and fear of infection.
 
Conclusion
In future pandemic lockdowns or crises, appropriate access to primary care services can be improved by unambiguous national messages and better integration of services. Primary care practices should adopt rapid proactive outreach to patients, fostering a calm but safe clinical practice environment. More support for patients to self-manage and self-triage appropriately could benefit over-burdened health systems during lockdowns and as part of business as usual in less extraordinary times.

Keywords

Main Subjects


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Articles in Press, Corrected Proof
Available Online from 13 April 2021
  • Receive Date: 16 December 2020
  • Revise Date: 09 March 2021
  • Accept Date: 13 March 2021