Prevalence and factors associated with non-utilization of health services in the Peruvian population with COVID-19 symptomatology: A secondary analysis of the 2020 National Household Survey.

Objectives: The objective of the study was to estimate the prevalence of non-use of health services (NUHS) and the associated factors in Peruvians with symptoms of COVID-19. Methods: A secondary analysis of the 2020 National Household Survey (ENAHO) was carried out. Participants over 18 years of age with any COVID-19 symptom (fever, cough, sensation of shortness of breath) in the last four weeks and did not go to the health services were defined as NUHS. Adjusted prevalence ratios were estimated to determine the factors associated with NUHS. Results: Data from 1856 participants were analyzed; the prevalence of NUHS was 52.2% (95% CI: 48.0-56.5). Living in the urban jungle (aPR = 1.61; 95% CI: 1.32-1.98; p <0.001) and rural jungle (aPR = 1.48; 95% CI: 1.15-1.90; p = 0.002) was associated with a higher probability of NUHS compared to living on the urban coast. The factors associated with a lower probability of NUHS were: being 50 to 59 years old (aPR = 0.72; 95% CI: 0.58-0.90) and 60 years and over (aPR = 0.74; 95% CI: 0.59- 0.95), having a secondary educational level (aPR = 0.67; 95% CI: 0.48-0.93), and superior (aPR = 0.67; 95% CI: 0.48-0.96), and having health insurance (aPR = 0.79; 95% CI: 0.68-0.92). Conclusion: More than half of the participants did not use health services, which was associated with the geographic and sociodemographic characteristics of the population. The formulation of health strategies and programs is required to increase the use of health services in the population with COVID-19 symptoms.