Sociodemographic predictors of missed and delayed health care among older Australians during the COVID-19 pandemic: Findings from the 45 and up COVID Insights study

Objectives: The COVID-19 pandemic disproportionately disrupted healthcare access for vulnerable populations, including older adults. This study examines sociodemographic predictors of missed or delayed care (MDC) among Australians aged ≥65 years across three pandemic time points (July–December 2020, June–August 2021, and March 2022). Methods: A repeated cross-sectional design was employed. Data were sourced from The 45 and Up COVID Insights study. Logistic regression analysed predictors of MDC, with sociodemographic variables including chronic conditions, psychological distress, cultural and linguistic diversity (CALD), disability status, gender, socioeconomic disadvantage, and geographic remoteness, included for analysis. Results: Three temporal patterns of MDC were identified: 1) Consistent MDC (i.e., those with ≥2 chronic conditions, higher psychological distress), 2) Early MDC (i.e., women, CALD, with disability, a carer, lived alone), and 3) Late MDC (i.e., men, older age, living in outer regional/rural/remote areas, most socioeconomically disadvantaged). Conclusion: Findings highlight the need for targeted policy responses to address persistent and emerging disparities in healthcare access among older adults, particularly for those with chronic illness, psychological distress, and those facing geographic or socioeconomic disadvantage.