{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,23]],"date-time":"2025-08-23T05:25:31Z","timestamp":1755926731549,"version":"3.37.3"},"reference-count":30,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2022,12,30]],"date-time":"2022-12-30T00:00:00Z","timestamp":1672358400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007601","name":"Horizon 2020","doi-asserted-by":"publisher","award":["101016167"],"award-info":[{"award-number":["101016167"]}],"id":[{"id":"10.13039\/501100007601","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010663","name":"H2020 European Research Council","doi-asserted-by":"publisher","award":["856478"],"award-info":[{"award-number":["856478"]}],"id":[{"id":"10.13039\/100010663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010663","name":"H2020 European Research Council","doi-asserted-by":"publisher","award":["SGY2019-856478"],"award-info":[{"award-number":["SGY2019-856478"]}],"id":[{"id":"10.13039\/100010663","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>In France, the first pandemic peak fell disproportionately on the most disadvantaged, as they were overrepresented in contaminations and in developing severe forms of the virus. At that time, and especially during lockdown, the French healthcare system was severely disrupted and limited. The issue of social differences in the use of healthcare by people experiencing symptoms of Covid-19 arose. Based on a random sample of 135,000 persons, we selected respondents who reported Covid-19-like symptoms (cough, fever, dyspnea, anosmia and\/or ageusia) during the first lockdown (n = 12,422). The aim of this study was to determine if the use of health care services was likely to contribute to widen Covid-19 social inequalities. Use of health care services was classified in three categories: (1) no consultation, (2) out-of-hospital consultation(s) and (3) in-hospital consultation(s). We estimated odds ratio of utilization of health care using multinomial regressions, adjusted on social factors (age, gender, class, ethno-racial status, social class, standard of living and education), contextual variables, health variables, and symptoms characteristics. Altogether, 37.8% of the individuals consulted a doctor for their symptoms; 32.1% outside hospital and 5.7% in hospital. Use of health care services was strongly associated with social position2: the most disadvantaged social groups and racially minoritized immigrants were more likely to use health care, particularly for in-hospital consultation(s). The highest utilization of health care were found among older adults (OR 9.51, 95%CI 5.02\u201318.0 compared to the youngest age group), the racially minoritized first-generation immigrants (OR 1.61, 95%CI 1.09\u20132.36 compared to the mainstream population), the poorest (OR 1.31, 95%CI 1.00\u20131.72) and the least educated (OR 2.20, 95%CI 1.44\u20133.38). To conclude, we found that the use of health care services counteracted the potential impact of social inequalities in exposure and infection to the Covid-19.<\/jats:p>","DOI":"10.1371\/journal.pone.0279538","type":"journal-article","created":{"date-parts":[[2022,12,30]],"date-time":"2022-12-30T18:27:51Z","timestamp":1672424871000},"page":"e0279538","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Use of health care services among people with Covid-19 symptoms in the first pandemic peak in France"],"prefix":"10.1371","volume":"17","author":[{"given":"Jeanna-Eve","family":"Pousson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L\u00e9na","family":"Silberzan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florence","family":"Jusot","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurence","family":"Meyer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8590-7952","authenticated-orcid":true,"given":"Josiane","family":"Warszawski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8073-9056","authenticated-orcid":true,"given":"Nathalie","family":"Bajos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on behalf of the EpiCoV study group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,12,30]]},"reference":[{"key":"pone.0279538.ref001","article-title":"Caract\u00e9ristiques socio-\u00e9conomiques des individus aux formes s\u00e9v\u00e8res de Covid-19 au fil des vagues \u00e9pid\u00e9miques","volume":"56","author":"L Galiana","year":"2022","journal-title":"Doss DREES"},{"key":"pone.0279538.ref002","first-page":"29","article-title":"Ethnicity and clinical outcomes in COVID-19: A systematic review and meta-analysis","author":"S Sze","year":"2020","journal-title":"EClinicalMedicine"},{"key":"pone.0279538.ref003","doi-asserted-by":"crossref","first-page":"e240","DOI":"10.1016\/S2468-2667(22)00007-X","article-title":"The effect of social deprivation on the dynamic of SARS-CoV-2 infection in France: a population-based analysis","volume":"7","author":"S Vandentorren","year":"2022","journal-title":"Lancet Public Health"},{"key":"pone.0279538.ref004","unstructured":"Warszawski J, Bajos N, Costemalle V, Leblanc S, \u00e9quipe EpiCov. 4% de la population a d\u00e9velopp\u00e9 des anticorps contre le SARS-CoV-2 entre mai et novembre 2020. Etudes R\u00e9sultats. 2021 [cited 25 Jul 2022]. https:\/\/drees.solidarites-sante.gouv.fr\/sites\/default\/files\/2021-07\/ER1202_0.pdf"},{"key":"pone.0279538.ref005","doi-asserted-by":"crossref","first-page":"e052888","DOI":"10.1136\/bmjopen-2021-052888","article-title":"Social inequalities and dynamics of the early COVID-19 epidemic: a prospective cohort study in France","volume":"11","author":"N Bajos","year":"2021","journal-title":"BMJ Open"},{"key":"pone.0279538.ref006","doi-asserted-by":"crossref","first-page":"e2134147","DOI":"10.1001\/jamanetworkopen.2021.34147","article-title":"Disparities in COVID-19 Outcomes by Race, Ethnicity, and Socioeconomic Status: A Systematic Review and Meta-analysis","volume":"4","author":"S Magesh","year":"2021","journal-title":"JAMA Netw Open"},{"key":"pone.0279538.ref007","doi-asserted-by":"crossref","first-page":"e0247461","DOI":"10.1371\/journal.pone.0247461","article-title":"Population risk factors for severe disease and mortality in COVID-19: A global systematic review and meta-analysis","volume":"16","author":"A Booth","year":"2021","journal-title":"PLOS ONE"},{"key":"pone.0279538.ref008","doi-asserted-by":"crossref","first-page":"e042119","DOI":"10.1136\/bmjopen-2020-042119","article-title":"How GPs adapted their practices and organisations at the beginning of COVID-19 outbreak: a French national observational survey","volume":"10","author":"O Saint-Lary","year":"2020","journal-title":"BMJ Open"},{"key":"pone.0279538.ref009","doi-asserted-by":"crossref","DOI":"10.3389\/frsc.2021.643821","article-title":"Covid-19 Lockdown in Spring 2020 in France Provided Unexpected Opportunity to Assess Health Impacts of Falls in Air Pollution","volume":"3","author":"L Ad\u00e9la\u00efde","year":"2021","journal-title":"Front Sustain Cities"},{"key":"pone.0279538.ref010","first-page":"4","article-title":"Keeping what works: remote consultations during the Covid-19 pandemic","volume":"26","author":"E Richardson","year":"2020","journal-title":"Eurohealth"},{"key":"pone.0279538.ref011","unstructured":"OECD. 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