New report highlights impact of 2020 COVID-19 lockdown on health care experience of disabled people

The Health Quality & Safety Commission (the Commission) has today released a report on the health care experience of around 4,000 disabled people during last year’s COVID-19 lockdown.

The health care experience of disabled people during COVID-19: Summary of findings from the COVID-19 patient experience survey | Te wheako tauwhiro hauora a te hunga hauā i te wā KOWHEORI-19: He whakarāpopototanga o ngā kitenga o te tiro whānui KOWHEORI-19 was created in partnership with interested primary health organisations to understand the impacts of COVID-19 on consumers accessing health care during lockdown. The survey revealed some important information about how health care was experienced by disabled people in particular.

Associate Professor of Medicine at the University of Otago Wellington and Commission board member Dr Tristram Ingham says, ‘This is the first time the Commission has been able to report data for this important population. The findings demonstrated a significant impact on disabled people, who make up around 24 percent of the population in Aotearoa New Zealand.’

Between June and July 2020, the survey participants were asked about their experience of health care during and after the first COVID-19 lockdown which lasted from 23 March to 13 May 2020. Disabled people were more likely than non-disabled to report they found barriers to accessing care during the lockdown period. Many disabled people chose not to try and get health care during the first lockdown. One of the reasons was not wanting to go to places where people get sick and concerns around catching COVID-19. Of those who did seek care, only around half of the participants received same or next-day care.

The survey also highlighted issues with the overall quality of care that disabled people received. Disabled respondents reported worse experiences from their GP and more likely to say their individual needs and/or cultural needs were not met.

Disabled people were more likely to have virtual appointments using telehealth. While telehealth options flourished during the lockdown period, and some disabled people found it met their health care needs, for others it did not. Telehealth is not the only solution.

Dr Ingham says, ‘There are long-term impacts on the health of disabled people resulting from lower access to inclusive education, accessible housing and employment. Barriers to transport and accessibility are especially common issues for some. The COVID-19 pandemic has amplified many inequities that disabled people have faced within the health system and broader society.

‘On the plus side, the pandemic has served as a catalyst, leading to rapid innovation of more accessible services, which the disabled communities have been calling on for some years.’

Dr Ingham says the health care system and the Commission have Te Tiriti o Waitangi obligations to tāngata whaikaha Māori (disabled Māori). The Commission is taking its Te Tiriti commitment seriously by expanding its capabilities in disability data monitoring and promoting leadership opportunities for tāngata whaikaha Māori.

‘We call on each service and practice to identify the inequities for people with disabilities to make their services and facilities accessible. We know the health care system can be difficult to navigate. Disabled people need to be involved at all levels of the health system, they have particular expertise and experiences to contribute. Partnering with disabled communities is a critical component of achieving equity in the health care system and equitable outcomes.’

The full report, methodology, summary and Easy Read summary translation are available here. Other alternate formats are being developed and will be published when ready.

Main findings about how disabled people experienced health care during the 2020 lockdown

• Disabled people were more likely to use virtual (phone or video) appointments during lockdown.
• Only around half of the disabled people in the survey said they got to see their doctor on the same day or the next working day, although this varied depending on where they lived in New Zealand. This means some people could have been seen and treated sooner, which may have affected their care.
• Disabled people surveyed were more likely than other people to say that their individual needs and/or cultural needs were not met during their most recent appointment.
• Picking up prescriptions from the pharmacy became more difficult for disabled people during lockdown (although getting prescriptions from their doctor was easier or ‘about the same’ as before). Social distancing put some people off. Other reasons included a fear of traveling due to the anxiety of catching COVID-19 and medicines only being available in a one-month supply, compared with the usual three-month supply.
• Despite being more likely to have a regular GP, during the lockdown disabled patients reported generally having a worse experience with their GP.