Impact of COVID-19 on unmet needs for healthcare in Peru: an interrupted time series analysis.

Abstract

The COVID-19 pandemic affected people's health and access to healthcare worldwide. Still, little is known about how distinct phases of the pandemic - namely the lockdown period and the period directly after lockdown - impacted these outcomes, and whether there were differences in these impacts among different segments of the Peruvian population. The aim of this study was to examine the impact of different phases of the COVID-19 response on unmet needs for healthcare across Peru. Using an interrupted time series design, this study analyzed quarterly data from Peru's National Household Survey on Living Conditions and Poverty (ENAHO) from 2018 to 2022. Outcome variables included people reporting having a health problem in the last 4 weeks and, among those reporting a problem, whether they had needed and sought care. These outcomes were stratified by demographic characteristics (i.e., by age group, gender, disability, indigenous status, regions, and rural/urban). Step and trend changes in outcomes during and directly after lockdown periods were compared to the pre-pandemic period. Overall, the prevalence of health problems decreased by 18.4 percentage points (pp) during the lockdown period compared to pre-pandemic levels, although unmet healthcare needs increased by 16.7 pp. Once lockdowns were removed, prevalence of health problems and access to healthcare increased slightly, but remained below pre-pandemic levels. Certain groups, namely people with disabilities, indigenous people and people in rural areas, had persistently worse health and poorer access to care. Persistent disparities in unmet healthcare needs highlight the necessity of targeted interventions to address systemic barriers faced by vulnerable populations and ensure continuity of care during health crises.