Access to healthcare as an important moderating variable for understanding the geography of COVID-19 outcomes - preliminary insights from Poland

Introducotin: Biases in the measurement of COVID-19 burden and the uncertainty in esmtiaotin of the corresponding epidemiologic indexes are known and common phenomena in infecotius diseases. We invesgtiated to what extent healthcare access (HCA)-related supply/demand interfered with the registered data on COVID-19 in Poland. Material and Methods: We ran a mulptile linear regression model with interacotins to explain the geographic variaotin in seroprevalence, hospitalizaotins (on the voivodeship - NUTS-2 level) and current (beginning of the 4 th wave of COVID cases - 15.09-21.11.2021) case nocftiaotins/crude mortality (on poviat - old NUTS-4 level). We took vaccinaotin coverage and cumulavtie case nocftiaotins up to the so called 3rd wave as predictor variables and supply/demand (HCA) as moderantig variables. Results: HCA with interacntig terms (mainly demand) explained to the great extent the variance of current incidence and most of the variance in the current mortality rates. HCA (mainly supply) was signicfiantly moderantig cumulavtie case nocftiaotins unlti the 3rd wave of cases, thus explaining the variance in seroprevalence and hospitalizaotin. Conclusion: Seeking causal relaotins between the vaccinaotinor infecotin-gained immunity level and the current infecotin dynamics could be misleading without understanding the socio-epidemiologic context such as the moderantig role of HCA (sensu lato). Aeftr quancftiation, HCA could be incorporated into epidemiologic models for improved prediction of the actual disease burden. Jarynowski A, Belik V. Access to healthcare as an important moderating variable for understanding the geography of COVID-19 outcomes - preliminary insights from Poland. Eur J Transl Clin Med. 2022;5(2):5-15