Delayed health care access is a potential collateral effect of pandemic conditions, health rationing strategies and social distancing responses. We investigated experiences of delayed health care access in Australian women during COVID-19. A mixed methods study used quantitative and free-text data from the Australian Longitudinal Study on Women's Health COVID-19 survey 4 (health care access or delay). Logistic regression models were used to estimate factors associated with delaying access to general practitioners (GPs), specialists and allied health services. Free-text comments were analysed thematically, employing a process of constant comparison. COVID-19 survey 4 was completed by 8,200 women and 2,727 provided free-text comments. Of the women who needed the health service, 25% (1,268/5,071) delayed seeing their GP, 23.6% (570/1,695) delayed seeing a specialist and 45% (791/1,757) delayed use of an allied health service. Younger age was most significantly associated with delaying attendance. Women born 1989–95 were significantly more likely to delay compared to women born 1946–51 (OR (95% CI): GP = 0.28 (0.22, 0.35)); Specialist = 0.65 (0.45, 0.92; Allied Health = 0.59 (0.42, 0.82)). Women born 1973–78 were also likely to delay GP visits (0.69, (0.58, 0.83)). Four qualitative themes emerged including: (1) Challenges negotiating care during a pandemic; (2) Ongoing uncertainty towards accessing health care when a specialist delays an appointment; (3) Accessing health care (or not) using Telehealth and (4) Managing complex care needs. COVID-19 has had a significant effect on access to health care. Women delayed seeking help for cancer screening, mental health, and other health conditions involving chronic and complex needs for health and social care. While there is a need to rationalise and optimise health access during a pandemic, our outcomes suggest a need for public health campaigns that clarify how to access care, engage with telehealth and respond to missed appointments.

中文翻译：

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澳大利亚妇女在 COVID 19 大流行期间延迟获得医疗保健的经历：混合方法探索

延迟获得医疗保健是大流行病、健康配给策略和社会疏远反应的潜在附带影响。我们调查了 COVID-19 期间澳大利亚妇女延迟获得医疗保健的经历。一项混合方法研究使用了来自澳大利亚妇女健康 COVID-19 纵向研究调查 4（医疗保健访问或延迟）的定量和自由文本数据。逻辑回归模型用于估计与延迟获得全科医生 (GP)、专家和专职医疗服务相关的因素。对自由文本评论进行主题分析，采用不断比较的过程。COVID-19 调查 4 由 8,200 名女性完成，2,727 名提供自由文本评论。在需要医疗服务的女性中，25% (1,268/5,071) 推迟看全科医生，23.6% (570/1, 695) 延迟看专科医生，45% (791/1,757) 延迟使用专职医疗服务。年龄较小与延迟出勤率最显着相关。与 1946-51 年出生的女性相比，1989-95 年出生的女性更容易延迟（OR (95% CI)：GP = 0.28 (0.22, 0.35)）；专家 = 0.65 (0.45, 0.92; Allied Health = 0.59 (0.42, 0.82))。1973-78 年出生的女性也可能延迟 GP 就诊 (0.69, (0.58, 0.83))。出现了四个定性主题，包括：（1）在大流行期间协商护理的挑战；(2) 当专家延迟预约时，获得医疗保健的持续不确定性；(3) 使用远程医疗获得（或不获得）医疗保健和 (4) 管理复杂的护理需求。COVID-19 对获得医疗保健产生了重大影响。女性推迟寻求癌症筛查、心理健康、以及其他涉及对健康和社会护理的长期和复杂需求的健康状况。虽然有必要在大流行期间合理化和优化医疗服务，但我们的结果表明，需要开展公共卫生运动，阐明如何获得医疗服务、参与远程医疗和应对错过的预约。