Unaffordability of COVID-19 tests: assessing age-related inequalities in 83 countries
Abstract Background Diagnostic testing for SARS-CoV-2 is critical to manage the pandemic and its different waves. The requirement to pay out-of-pocket (OOP) for testing potentially represents both a financial barrier to access and, for those who manage to make the payment, a source of financial hard...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-12-01
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| Series: | International Journal for Equity in Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12939-022-01784-4 |
| _version_ | 1797865240928452608 |
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| author | Gabriela Flores Asiyeh Abbasi Catherine Korachais Rouselle Lavado |
| author_facet | Gabriela Flores Asiyeh Abbasi Catherine Korachais Rouselle Lavado |
| author_sort | Gabriela Flores |
| collection | DOAJ |
| description | Abstract Background Diagnostic testing for SARS-CoV-2 is critical to manage the pandemic and its different waves. The requirement to pay out-of-pocket (OOP) for testing potentially represents both a financial barrier to access and, for those who manage to make the payment, a source of financial hardship, as they may be forced to reduce spending on other necessities. This study aims to assess age-related inequality in affordability of COVID-19 tests. Methods Daily data from the Global COVID-19 Trends and Impact Survey among adult respondents across 83 countries from July 2020 to April 2021 was used to monitor age-related inequalities across three indicators: the experiences of, first, reducing spending on necessities because of paying OOP for testing, second, facing financial barriers to get tested (from January to April 2021), and third, having anxiety related to household finance in the future. Logistic regressions were used to assess the association of age with each of these. Results Among the population ever tested, the adjusted odds of reducing spending on necessities due to the cost of the test decreased non-linearly with age from 2.3 [CI95%: 2.1–2.5] among ages 18–24 to 1.6 [CI95%: 1.5–1.8] among ages 45–54. Among the population never tested, odds of facing any type of barrier to testing were highest among the youngest age group 2.5 [CI95%:2.4–2.5] and decreased with age. Finally, among those reporting reducing spending on necessities, the odds of reporting anxiety about their future finances decreased non-linearly with age, with the two younger groups being 2.4–2.5 times more anxious than the oldest age group. Among those reporting financial barriers due to COVID-19 test cost, there was an inverse U-shape relationship. Conclusions COVID-19 testing was associated with a reduction in spending on necessities at varying levels by age. Younger people were more likely to face financial barrier to get tested. Both negative outcomes generated anxiety across all age-groups but more frequently among the younger ones. To reduce age-related inequalities in the affordability of COVID-19 test, these findings support calls for exempting everyone from paying OOP for testing and, removing other type of barriers than financial ones. |
| first_indexed | 2024-04-09T23:04:55Z |
| format | Article |
| id | doaj.art-27ae6eda122f465baf380b66b6f17407 |
| institution | Directory Open Access Journal |
| issn | 1475-9276 |
| language | English |
| last_indexed | 2024-04-09T23:04:55Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal for Equity in Health |
| spelling | doaj.art-27ae6eda122f465baf380b66b6f174072023-03-22T10:43:48ZengBMCInternational Journal for Equity in Health1475-92762022-12-0121S311610.1186/s12939-022-01784-4Unaffordability of COVID-19 tests: assessing age-related inequalities in 83 countriesGabriela Flores0Asiyeh Abbasi1Catherine Korachais2Rouselle Lavado3Economic Evaluation and Analysis, Health Systems Governance and Financing, World Health OrganizationConsultant, World Health OrganizationConsultant, World Health OrganizationEconomic Evaluation and Analysis, Health Systems Governance and Financing, World Health OrganizationAbstract Background Diagnostic testing for SARS-CoV-2 is critical to manage the pandemic and its different waves. The requirement to pay out-of-pocket (OOP) for testing potentially represents both a financial barrier to access and, for those who manage to make the payment, a source of financial hardship, as they may be forced to reduce spending on other necessities. This study aims to assess age-related inequality in affordability of COVID-19 tests. Methods Daily data from the Global COVID-19 Trends and Impact Survey among adult respondents across 83 countries from July 2020 to April 2021 was used to monitor age-related inequalities across three indicators: the experiences of, first, reducing spending on necessities because of paying OOP for testing, second, facing financial barriers to get tested (from January to April 2021), and third, having anxiety related to household finance in the future. Logistic regressions were used to assess the association of age with each of these. Results Among the population ever tested, the adjusted odds of reducing spending on necessities due to the cost of the test decreased non-linearly with age from 2.3 [CI95%: 2.1–2.5] among ages 18–24 to 1.6 [CI95%: 1.5–1.8] among ages 45–54. Among the population never tested, odds of facing any type of barrier to testing were highest among the youngest age group 2.5 [CI95%:2.4–2.5] and decreased with age. Finally, among those reporting reducing spending on necessities, the odds of reporting anxiety about their future finances decreased non-linearly with age, with the two younger groups being 2.4–2.5 times more anxious than the oldest age group. Among those reporting financial barriers due to COVID-19 test cost, there was an inverse U-shape relationship. Conclusions COVID-19 testing was associated with a reduction in spending on necessities at varying levels by age. Younger people were more likely to face financial barrier to get tested. Both negative outcomes generated anxiety across all age-groups but more frequently among the younger ones. To reduce age-related inequalities in the affordability of COVID-19 test, these findings support calls for exempting everyone from paying OOP for testing and, removing other type of barriers than financial ones.https://doi.org/10.1186/s12939-022-01784-4Covid-19 testingFinancial protectionAccessibilityCatastrophic health expenditureAge-related inequalities |
| spellingShingle | Gabriela Flores Asiyeh Abbasi Catherine Korachais Rouselle Lavado Unaffordability of COVID-19 tests: assessing age-related inequalities in 83 countries International Journal for Equity in Health Covid-19 testing Financial protection Accessibility Catastrophic health expenditure Age-related inequalities |
| title | Unaffordability of COVID-19 tests: assessing age-related inequalities in 83 countries |
| title_full | Unaffordability of COVID-19 tests: assessing age-related inequalities in 83 countries |
| title_fullStr | Unaffordability of COVID-19 tests: assessing age-related inequalities in 83 countries |
| title_full_unstemmed | Unaffordability of COVID-19 tests: assessing age-related inequalities in 83 countries |
| title_short | Unaffordability of COVID-19 tests: assessing age-related inequalities in 83 countries |
| title_sort | unaffordability of covid 19 tests assessing age related inequalities in 83 countries |
| topic | Covid-19 testing Financial protection Accessibility Catastrophic health expenditure Age-related inequalities |
| url | https://doi.org/10.1186/s12939-022-01784-4 |
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