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Stroke but no hospital admission: Lost opportunity for whom?

Author

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  • Carine Milcent
  • Hanta Ramaroson
  • Fleur Maury
  • Florence Binder-Foucard
  • Marie Moitry
  • Anne-Marie Moulin

Abstract

To counter the spread of COVID-19, the French government imposed several stringent social and political measures across its entire population. We hereto assess the impact of these political decisions on healthcare access in 2020, focusing on patients who suffered from an ischemic stroke. We divide our analysis into four distinct periods: the pre-COVID-19 pandemic period, the lockdown period, the “in-between” or transitional period, and the shutdown period. Our methodology involves utilizing a retrospective dataset spanning 2019–2020, an exhaustive French national hospital discharge diagnosis database for stroke inpatients, integrated with income information from the reference year of 2019. The results reveal that the most affluent were more likely to forgo medical care, particularly in heavily affected areas. Moreover, the most disadvantaged exhibited even greater reluctance to seek care, especially in the most severely impacted regions. The data suggest a loss of opportunity for less severely affected patients to benefit from healthcares during this lockdown period, regardless of demographic, location, and socioeconomic determinants. Furthermore, our analysis reveals a notable discrepancy in healthcare-seeking behavior, with less affluent patients and seniors (over 75 years old) experiencing slower rates of return to healthcare access compared to pre-pandemic levels. This highlights a persistent gap in healthcare accessibility, particularly among socioeconomically disadvantaged groups, despite the easing of COVID-19 restrictions.

Suggested Citation

  • Carine Milcent & Hanta Ramaroson & Fleur Maury & Florence Binder-Foucard & Marie Moitry & Anne-Marie Moulin, 2024. "Stroke but no hospital admission: Lost opportunity for whom?," PLOS ONE, Public Library of Science, vol. 19(8), pages 1-18, August.
  • Handle: RePEc:plo:pone00:0307220
    DOI: 10.1371/journal.pone.0307220
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    References listed on IDEAS

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    1. Clark, Andrew E. & Milcent, Carine, 2018. "Ownership and hospital behaviour: Employment and local unemployment," Social Science & Medicine, Elsevier, vol. 202(C), pages 151-161.
    2. Milcent, Carine, 2023. "The sorting effect in healthcare access: Those left behind," Economics & Human Biology, Elsevier, vol. 51(C).
    3. Fayaz Farkhad, Bita & Albarracín, Dolores, 2021. "Insights on the implications of COVID-19 mitigation measures for mental health," Economics & Human Biology, Elsevier, vol. 40(C).
    4. Akay, Alpaslan, 2022. "The local and global mental health effects of the Covid-19 pandemic," Economics & Human Biology, Elsevier, vol. 45(C).
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