Evidence map›Paper›PMID 41918098›Full record

ArticleBMC public health2026

Care delay during the COVID-19 pandemic in Germany - a cross-sectional online survey in the NAKO study.

Janka Massag, Theresa Herrmann, Laura R Pfrommer, Amand Führer, Klaus Berger, Hermann Brenner, Karina Karolina De Santis, Karin Halina Greiser, Volker Harth, André Karch and 20 more

Abstract read
In one paragraph

Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

30 authors.

Janka MassagInstitute for Medical Epidemiology, Biometrics and Informatics (IMEBI), Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Universitätsmedizin Halle - Universitätsklinikum Halle (Saale), Magdeburger Straße 8, 06112, Halle (Saale), Germany.
Theresa HerrmannInstitute for Medical Epidemiology, Biometrics and Informatics (IMEBI), Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Universitätsmedizin Halle - Universitätsklinikum Halle (Saale), Magdeburger Straße 8, 06112, Halle (Saale), Germany.
Laura R PfrommerInstitute for Medical Epidemiology, Biometrics and Informatics (IMEBI), Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Universitätsmedizin Halle - Universitätsklinikum Halle (Saale), Magdeburger Straße 8, 06112, Halle (Saale), Germany.
Amand FührerInstitute for Medical Epidemiology, Biometrics and Informatics (IMEBI), Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Universitätsmedizin Halle - Universitätsklinikum Halle (Saale), Magdeburger Straße 8, 06112, Halle (Saale), Germany.
Klaus BergerInstitute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
Hermann BrennerGerman Cancer Research Center (DKFZ), Heidelberg, Germany.
Karina Karolina De SantisLeibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
Karin Halina GreiserGerman Cancer Research Center (DKFZ), Heidelberg, Germany.
Volker HarthInstitute of Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
André KarchInstitute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
Thomas KeilInstitute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Muhammad Nasir Khan KhattakDepartment of Study of Health in Pomerania (SHIP)/ Clinical-Epidemiological Research (KEF), Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
Carolina J Klett-TammenDepartment of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany.
Lilian KristInstitute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Niels O KristiansenDepartment of Study of Health in Pomerania (SHIP)/ Clinical-Epidemiological Research (KEF), Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
Benedikt LamplRegensburg Department of Public Health, Regensburg, Germany.
Michael LeitzmannDepartment of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.
Wolfgang LiebInstitute of Epidemiology, Kiel University, Kiel, Germany.
Ute MonsGerman Cancer Research Center (DKFZ), Heidelberg, Germany.
Ilais Moreno VelásquezMax-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research Group, Berlin, Germany.
Alexandra NietersCentre for Chronic Immunodeficiency, University Medical Center Freiburg, Freiburg, Germany.
Nadia ObiInstitute of Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Cara ÖvermöhleInstitute of Epidemiology, Kiel University, Kiel, Germany.
Anette PetersInstitute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany.
Tobias PischonMax-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research Group, Berlin, Germany.
Börge SchmidtInstitute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany.
Matthias B SchulzeDepartment of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
Kerstin WirknerLeipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany.
Hajo ZeebLeibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
Rafael MikolajczykInstitute for Medical Epidemiology, Biometrics and Informatics (IMEBI), Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Universitätsmedizin Halle - Universitätsklinikum Halle (Saale), Magdeburger Straße 8, 06112, Halle (Saale), Germany. Rafael.mikolajczyk@uk-halle.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDuring the COVID-19 pandemic, non-COVID-19 related healthcare utilization declined in Germany, resulting in care delay, including delays and cancellations of routine, chronic, and even acute care. The aim of this study was to investigate factors (i.e. regional differences and participant characteristics) associated with care delay during the pandemic in Germany using a cross-sectional survey.

methodsIn October 2022, a total of 117,466 participants from the German National Cohort (NAKO) study completed an online questionnaire on pandemic-related topics, including care delay during the COVID-19 pandemic. Regional differences and participant characteristics associated with care delay were assessed using (multilevel) logistic regression.

resultsOne third of participants reported having experienced care delay. Care delay did not differ across the 13 federal states or 32 districts in Germany for which sufficient data were available. In the medical practice setting, care delay was nearly equally provider- and patient-related and was reported mostly for routine check-ups. In the hospital setting, care delay was predominantly provider-related and reported for newly occurring conditions. The odds for care delay were higher in females vs. males (odds ratio (OR): 1.30; 95% confidence interval (CI): 1.27–1.34), and in participants with vs. without chronic conditions (e.g. mental disorders, OR: 1.41, 95%CI: 1.36–1.46 or cardiovascular diseases, OR: 1.20 95%CI: 1.16–1.24) and decreased with age (e.g. 70 + vs. 50–59 years, OR: 0.59, 95%CI: 0.57–0.62).

conclusionCare delay during the COVID-19 pandemic depended on participant characteristics including age, sex, and preexisting chronic conditions but not on regional (i.e. state and district-level) differences in Germany.

Indexed as

COVID-19AdultAgedCross-Sectional StudiesFemaleGermanyHumansMaleMiddle AgedPandemicsSurveys and QuestionnairesTreatment DelayCOVID-19 PandemicDelayed DiagnosisGermanyHealth Services AccessibilityNAKOSurvey

Identifiers

PMID41918098
PMCPMC13063876

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.