Socio-demographic characteristics and their relation to medical service consumption among elderly in Israel during the COVID-19 lockdown in 2020 as compared to the corresponding period in 2019

  1. Ohad Shaked
  2. Liat Korn
  3. Yair Shapiro
  4. Gideon Koren
  5. Avi Zigdon

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Abstract

The COVID-19 pandemic has led to the isolation of the population in Israel, including the elderly. The present study aimed to compare the consumption of medical services among adults over the age of 65 in Israel at the time of the first COVID-19 lockdown relative to the corresponding period the year before.

Methods

We conducted a retrospective longitudinal observational quantitative research based on the Natali Healthcare Solutions Israel database of subscribers. Company subscribers over the age of 65 (N = 103,955) were included in the sample (64.5% women) in two time periods, before the COVID-19 outbreak-P1, in 2019, and during the first COVID-19 lockdown- P2 in 2020. Logistic regression was applied to examine service consumption for study variables.

Results

The average number of referrals to services was lower during the COVID-19 lockdown period (M = 0.3658, SD = 0.781) compared to the corresponding period in the previous year (M = 0.5402, SD = 0.935). The average number of ambulance orders, doctor home visits and service refusals were higher when compared to the same period in the previous year. During both time periods, women (P1- M = 0.5631, SD = 0.951; P2- M = 0.3846, SD = 0.800) required significantly more ( p < . 000 ) services than men (P1- M = 0.5114, SD = 0.910; P2- M = 0.3417, SD = 0.753). Older, widowed people, living in non-Jewish/mixed localities, or in average or below average socioeconomic status localities required relatively more services to those with opposite socio-demographic traits ( p < . 000 ).

Summary and conclusions

In a large sample of elderly in Israel, findings indicate a decrease in referrals to medical care during the first COVID-19 lockdown period, yet an increase in ambulance orders, doctor visits and service refusals. Socio-demographic characteristics showed a similar effect in both time periods. The period of the first COVID-19 lockdown was characterized by a higher incidence of medical service refusals as compared to the equivalent period in the previous year.

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  1. Version published to 10.1371/journal.pone.0278893
  2. ScreenIT

    SciScore for 10.1101/2022.01.29.22269933: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIACUC: The study was approved by the Ariel University institutional ethics
    Sex as a biological variableTable 1 shows the sample included 64.5% women (n=65,954) and 35.5% men (n=36,364).
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Data Analysis: For data analysis purposes, the file was centralized in a data table in the IBM SPSS Statistics 25 software.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    On the other hand, part of the study limitations is the lack of information pertaining to additional data such as the degree of religiosity, which could not be unequivocally examined since the data was based solely on place of residence, and not based on self-report. Another study limitation is that potential intervention variables such as disease severity, number of diseases, mental state, and nutritional balance, were not taken into account in this study, given the unavailability of this data. The findings of the study show that there is a decrease in referrals to medical centers during times of emergency as well as during the first COVID-19 lockdown period, but an increase in the demand for medical services such as ambulance orders and doctor’s home visits as well as service refusals. There is no significant difference in the trends of the findings between the time periods according to different socio-demographic characteristics. The pandemic period raised concerns among the elderly about receiving medical care, possibly due to fear of contracting the disease, and was characterized by a higher incidence of medical service refusals during the pandemic. Consumption of services among the elderly during COVID-19 decreased during the first lockdown compared to the previous year. The elderly’s fear of receiving services from an unfamiliar person / the fear of unnecessary exposure is known in times of crisis when people who are in distress avoid calling security services and try ...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  3. Version published to 10.1101/2022.01.29.22269933 on medRxiv