Navigating COVID-19: Association between public perceptions of preventive measures and delayed or foregone care among young and middle-aged Korean adults in the early phase of the pandemic

The COVID-19 pandemic has had a profound impact on healthcare systems worldwide, leading to significant disruptions in healthcare services and an increase in delayed or foregone care. South Korea has been no exception. While the importance of public perceptions of COVID-19 and healthcare use has been recognized, how such perceptions shape healthcare-seeking behaviour remains underexplored in the Korean context. The aim of this study was to examine the association between public perceptions of preventive measures and instances of delayed or foregone care during the early phase of the pandemic in 2020. This study utilized data from the 2020 Koreans' Happiness Survey (KHS), a nationally representative cross-sectional dataset. The analysis included a total of 11,307 respondents, aged 19-64, who completed both the general and COVID-19 modules of the survey. To assess delayed or foregone care, self-reported responses were used. Public perceptions of COVID-19 preventive measures were categorised into four groups based on reported trust and understanding. The association between public perceptions of the preventive measures and delayed or foregone care was assessed using logistic regression analyses, which were adjusted for sociodemographic, health status, and COVID-19-related characteristics. The results of this study revealed that Korean adults, who both understood and trusted COVID-19 preventive measures, had significantly lower odds of delayed or foregone care (OR: 0.49, 95% CI: 0.36-0.65) as compared with those who lacked both. Chronic conditions, worsened health status, and lower income were associated with a higher likelihood of delayed or foregone care. These findings highlight that both cognitive and affective dimensions of public perceptions may have shaped the use of healthcare services during the public health crisis. During future public health emergencies, strengthening public trust and risk communication may be important to mitigate barriers to timely access to healthcare.