A crisis like no other? Unmet needs in healthcare during the first wave of the COVID-19 crisis in Austria

Background: Many patients experienced restricted access to healthcare during the Coronavirus Disease 2019
(COVID-19) pandemic. This study is among the first to provide systematic evidence on the existence of subjective
unmet needs (SUN) in different population groups during the pandemic. Methods: Using data on individuals aged
20–64 and living in Austria from the AKCOVID survey (June 2020) and the ‘European Social Survey’ (2015), SUN
were compared between 2015 and 2020, either related to the pandemic (fear of infection, provider closed or
treatment postponed) or not (barriers related to knowledge, affordability, time and reachability). Multinomial
logistic regression models identified determinants of SUN during the pandemic, adjusting for socio-demographics,
socio-economic status and self-reported health. Results: Shares of the population with SUN in 2020 substantially
exceeded SUN in 2015. Excess unmet needs were mostly attributable to the pandemic. Postponed treatments and
closed providers were the most important reasons for SUN in June 2020. Older age groups (50–64 years), inactive
and retired people were most likely to report pandemic-related SUN. We did not find socio-economic differences
in pandemic-related SUN. Conclusions: The pandemic resulted in a supply-side shock to healthcare, with vulner-
abilities emerging especially among older people, people with poor health and/or people no longer active on the
labour market. Further research could focus on health system resilience and the possibilities to improve manage-
ment of healthcare services during pandemics without widening inequalities while maintaining population
health.