TY - JOUR
T1 - Dutch GP healthcare consumption in COVID-19 heterogeneous regions
T2 - an interregional time-series approach in 2020-2021
AU - Homburg, Maarten Theodoor
AU - Berger, Marjolein
AU - Berends, Matthijs
AU - Meijer, Eline
AU - Kupers, Thijmen
AU - Ramerman, Lotte
AU - Rijpkema, Corinne
AU - de Schepper, Evelien
AU - Olde Hartman, Tim
AU - Muris, Jean
AU - Verheij, Robert
AU - Peters, Lilian
PY - 2023/12/21
Y1 - 2023/12/21
N2 - BACKGROUND: Many countries observed a sharp decline in the use of general practice services after the outbreak of the COVID-19 pandemic. However, research has not yet considered how changes in healthcare consumption varied among regions with the same restrictive measures but different COVID-19 prevalence. AIM: To investigate how the COVID-19 pandemic affected healthcare consumption in Dutch general practice during 2020 and 2021, among regions with known heterogeneity in COVID-19 prevalence, from a pre-pandemic baseline in 2019. DESIGN: Population-based cohort study using electronic health records. SETTING: Dutch general practices involved in regional research networks. METHODS: Interrupted time-series analysis of changes in healthcare consumption from before to during the pandemic. Descriptive statistics on the number of potential COVID-19 related contacts, reason for contact and type of contact. RESULTS: The study covered 3 627 597 contacts (425 639 patients), 3 532 693 contacts (433 340 patients), and 4 134 636 contacts (434 872 patients) in 2019, 2020, and 2021, respectively. Time-series analysis revealed a significant decrease in healthcare consumption after the outbreak of the pandemic. Despite interregional heterogeneity in COVID-19 prevalence, healthcare consumption decreased comparably over time in the three regions, before rebounding to a level significantly higher than baseline in 2021. Physical consultations transitioned to phone or digital over time. CONCLUSIONS: Healthcare consumption decreased irrespective of the regional prevalence of COVID-19 from the start of the pandemic, with the Delta variant triggering a further decrease. Overall, changes in care consumption appeared to reflect contextual factors and societal restrictions rather than infection rates.
AB - BACKGROUND: Many countries observed a sharp decline in the use of general practice services after the outbreak of the COVID-19 pandemic. However, research has not yet considered how changes in healthcare consumption varied among regions with the same restrictive measures but different COVID-19 prevalence. AIM: To investigate how the COVID-19 pandemic affected healthcare consumption in Dutch general practice during 2020 and 2021, among regions with known heterogeneity in COVID-19 prevalence, from a pre-pandemic baseline in 2019. DESIGN: Population-based cohort study using electronic health records. SETTING: Dutch general practices involved in regional research networks. METHODS: Interrupted time-series analysis of changes in healthcare consumption from before to during the pandemic. Descriptive statistics on the number of potential COVID-19 related contacts, reason for contact and type of contact. RESULTS: The study covered 3 627 597 contacts (425 639 patients), 3 532 693 contacts (433 340 patients), and 4 134 636 contacts (434 872 patients) in 2019, 2020, and 2021, respectively. Time-series analysis revealed a significant decrease in healthcare consumption after the outbreak of the pandemic. Despite interregional heterogeneity in COVID-19 prevalence, healthcare consumption decreased comparably over time in the three regions, before rebounding to a level significantly higher than baseline in 2021. Physical consultations transitioned to phone or digital over time. CONCLUSIONS: Healthcare consumption decreased irrespective of the regional prevalence of COVID-19 from the start of the pandemic, with the Delta variant triggering a further decrease. Overall, changes in care consumption appeared to reflect contextual factors and societal restrictions rather than infection rates.
KW - COVID-19
KW - General practice
KW - Health policy
KW - Patient Acceptance of Health Care
U2 - 10.3399/BJGPO.2023.0121
DO - 10.3399/BJGPO.2023.0121
M3 - Article
SN - 2398-3795
JO - BJGP Open
JF - BJGP Open
ER -