This paper combines SHARE Corona Survey and SHARE Wave 7 data for 25 European countries and Israel (N = 40,919) with institutional and epidemic-related country characteristics to investigate healthcare access for Europeans aged 50+ during the outbreak of COVID-19. We use a micro–macro approach to examine whether and to what extent barriers to accessing healthcare measured by reported unmet healthcare needs vary within and between countries. We consider various aspects of barriers and distinguish among: (1) respondents who forewent medical treatment because they were afraid of becoming infected with the Coronavirus; (2) respondents who had pre-scheduled medical appointments postponed by health providers due to the outbreak; and (3) respondents who tried to arrange a medical appointment but were denied one. Limited access to healthcare during the initial outbreak was more common for the occupationally active, women, the more educated and those living in urban areas. A bad economic situation, poor overall health and higher healthcare utilisation were robust predictors of unmet healthcare. People aged 50+ in countries of ‘Old’ Europe, countries with higher universal health coverage and stricter containment and closure policies were more likely to have medical services postponed. Policymakers should address the healthcare needs of older people with chronic health conditions and a poor socio-economic status who were made more vulnerable by this pandemic. In the aftermath of the health crisis, public health systems might experience a great revival in healthcare demand, a challenge that should be mitigated by careful planning and provision of healthcare services.

本文结合了 25 个欧洲国家和以色列的 SHARE Corona Survey 和 SHARE Wave 7 数据（N = 40,919）结合制度和流行病相关的国家特征，调查 COVID-19 爆发期间 50 岁以上欧洲人的医疗保健获取情况。我们使用微观-宏观方法来研究国家内部和国家之间通过报告的未满足的医疗保健需求来衡量获得医疗保健的障碍是否以及在多大程度上存在差异。我们考虑了各个方面的障碍，并区分：（1）因害怕感染冠状病毒而放弃医疗的受访者；(2) 因疫情爆发而被医疗服务提供者推迟的预先预约的医疗预约的受访者；(3) 试图安排医疗预约但被拒绝的受访者。在最初的疫情爆发期间，对于职业活跃人士、女性、受教育程度较高的人和居住在城市地区的人。糟糕的经济形势、较差的整体健康状况和较高的医疗保健利用率是医疗保健未得到满足的有力预测因素。在“老”欧洲国家、全民健康覆盖率较高、遏制和封锁政策更严格的国家，50岁以上的人更有可能推迟医疗服务。政策制定者应解决患有慢性疾病和社会经济状况不佳的老年人的医疗保健需求，他们因这一流行病而变得更加脆弱。健康危机过后，公共卫生系统可能会经历医疗保健需求的大幅复苏，这一挑战应通过仔细规划和提供医疗保健服务来缓解。整体健康状况不佳和医疗保健利用率较高是医疗保健未得到满足的有力预测因素。在“老”欧洲国家、全民健康覆盖率较高、遏制和封锁政策更严格的国家，50岁以上的人更有可能推迟医疗服务。政策制定者应解决患有慢性疾病和社会经济状况不佳的老年人的医疗保健需求，他们因这一流行病而变得更加脆弱。健康危机过后，公共卫生系统可能会经历医疗保健需求的大幅复苏，这一挑战应通过仔细规划和提供医疗保健服务来缓解。整体健康状况不佳和医疗保健利用率较高是医疗保健未得到满足的有力预测因素。在“老”欧洲国家、全民健康覆盖率较高、遏制和封锁政策更严格的国家，50岁以上的人更有可能推迟医疗服务。政策制定者应解决患有慢性疾病和社会经济状况不佳的老年人的医疗保健需求，他们因这一流行病而变得更加脆弱。健康危机过后，公共卫生系统可能会经历医疗保健需求的大幅复苏，这一挑战应通过仔细规划和提供医疗保健服务来缓解。全民健康覆盖率较高、遏制和封锁政策更为严格的国家更有可能推迟医疗服务。政策制定者应解决患有慢性疾病和社会经济状况不佳的老年人的医疗保健需求，他们因这一流行病而变得更加脆弱。健康危机过后，公共卫生系统可能会经历医疗保健需求的大幅复苏，这一挑战应通过仔细规划和提供医疗保健服务来缓解。全民健康覆盖率较高、遏制和封锁政策更为严格的国家更有可能推迟医疗服务。政策制定者应解决患有慢性疾病和社会经济状况不佳的老年人的医疗保健需求，他们因这一流行病而变得更加脆弱。健康危机过后，公共卫生系统可能会经历医疗保健需求的大幅复苏，这一挑战应通过仔细规划和提供医疗保健服务来缓解。