Socio-structural barriers and older adults' therapeutic itineraries to access healthcare during the COVID- 19 pandemic in Peru

这项博士研究将提出一个关键问题，即老年人占全球covid -19致命受害者的75%，这一事实是否真的主要是由于他们的身体性质。相反，我将研究老年人死亡率较高的一些原因是否可以在卫生保健系统的运作方式、他们对老年人的歧视做法（也称为制度性年龄歧视）以及大流行期间卫生服务机构的压倒性优势中找到。所有这些都可能限制或排除老年人接受治疗或接受适当的医疗保健。此外，我将确定老年患者及其家属必须制定的策略，以管理疾病并处理缺乏正规医疗保健的问题，这是一个尚未从社会科学和老年学方法研究的主题。该项目将把这一问题置于秘鲁，秘鲁是南美洲的一个低收入和中等收入国家，是世界上COVID-19死亡率最高的国家。与早期的研究相反，我的项目将采取定性研究方法，从涉及的关键参与者的角度和经验来分析这一关键主题：医疗保健提供者、老年患者及其家人。从这个意义上讲，该博士项目——将是拉丁美洲首个此类项目——希望获得更广泛的经验教训，以改善老年人在大流行后恢复期获得医疗保健服务的机会，并改善全世界发展中国家老年人的福祉和生命权。

This PhD research will ask the critical question of whether the fact that older people represent 75% ofCOVID-19 fatal victims worldwide is really primarily due to the nature of their bodies. Instead, I willexamine whether some of the reasons for the higher death rate among older people can be found in howthe healthcare system operates, their practices of discrimination against older people -also calledinstitutional ageism- and the overwhelming of health services during the pandemic. All that could havelimited or excluded older adults from getting treated or receiving appropriate healthcare. Additionally, Iwill identify the strategies that older patients and their families had to develop to manage the diseaseand deal with the lack of formal healthcare, a topic that has not yet been studied from a social scienceand gerontological approach. This project will place this problem in Peru, a low and middle-incomecountry of South America with the world's highest COVID-19 death rate. In contrast to earlier studies, myproject will take a qualitative research approach to analyse this critical subject from the perspectives andexperiences of the key actors involved: healthcare providers, older patients and their families. In thissense, this doctoral project -that would be the first of its kind in Latin America- wishes to obtain broaderlessons that could improve older people's access to healthcare provision in the post-pandemic recoveryperiod, as well as the wellbeing and right to life of older people in developing countries worldwide.