TY - JOUR T1 - Indirect impact of the COVID-19 pandemic and its containment measures on social inequalities in hospital utilisation in Italy JF - Journal of Epidemiology and Community Health JO - J Epidemiol Community Health SP - 707 LP - 715 DO - 10.1136/jech-2021-218452 VL - 76 IS - 8 AU - Chiara Di Girolamo AU - Roberto Gnavi AU - Tania Landriscina AU - Silvia Forni AU - Manuele Falcone AU - Enrico Calandrini AU - Giulia Cesaroni AU - Antonio Russo AU - Olivia Leoni AU - Caterina Fanizza AU - Alessandra Allotta AU - Giuseppe Costa AU - Teresa Spadea A2 - , Y1 - 2022/08/01 UR - http://jech.bmj.com/content/76/8/707.abstract N2 - Background The pandemic may undermine the equity of access to and utilisation of health services for conditions other than COVID-19. The objective of the study is to evaluate the indirect impact of COVID-19 and lockdown measures on sociodemographic inequalities in healthcare utilisation in seven Italian areas.Methods In this multicentre retrospective study, we evaluated whether COVID-19 modified the association between educational level or deprivation and indicators of hospital utilisation and quality of care. We also assessed variations in gradients by sex and age class. We estimated age-standardised rates and prevalence and their relative per cent changes comparing pandemic (2020) and pre-pandemic (2018–2019) periods, and the Relative Index of Inequalities (RIIs) fitting multivariable Poisson models with an interaction between socioeconomic position and period.Results Compared with 2018–2019, hospital utilisation and, to a lesser extent, timeliness of procedures indicators fell during the first months of 2020. Larger declines were registered among women, the elderly and the low educated resulting in a shrinkage (or widening if RII <1) of the educational gradients for most of the indicators. Timeliness of procedures indicators did not show any educational gradient neither before nor during the pandemic. Inequalities by deprivation were nuanced and did not substantially change in 2020.Conclusions The socially patterned reduction of hospital utilisation may lead to a potential exacerbation of health inequalities among groups who were already vulnerable before the pandemic. The healthcare service can contribute to contrast health disparities worsened by COVID-19 through more efficient communication and locally appropriate interventions.Data are available upon reasonable request. The health administrative databases which are the data sources of this study are not publicly available; the unidentifiable aggregated data will be available from the corresponding author upon reasonable request. ER -