Dutch GP healthcare consumption in COVID-19 heterogeneous regions: an interregional time-series approach in 2020-2021.

COVID-19 General practice Health policy Patient Acceptance of Health Care

Journal

BJGP open
ISSN: 2398-3795
Titre abrégé: BJGP Open
Pays: England
ID NLM: 101713531

Informations de publication

Date de publication:
21 Dec 2023
Historique:
received: 29 06 2023
revised: 22 09 2023
accepted: 01 11 2023
medline: 22 12 2023
pubmed: 22 12 2023
entrez: 21 12 2023
Statut: aheadofprint

Résumé

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. 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. Population-based cohort study using electronic health records. Dutch general practices involved in regional research networks. 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. 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. 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.

Sections du résumé

BACKGROUND 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 OBJECTIVE
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 METHODS
Population-based cohort study using electronic health records.
SETTING METHODS
Dutch general practices involved in regional research networks.
METHODS 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 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 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.

Identifiants

DOI: 10.3399/BJGPO.2023.0121 PMID: 38128964
pubmed: 38128964
pii: BJGPO.2023.0121
doi: 10.3399/BJGPO.2023.0121
pii:
doi:

Types de publication

Journal Article

Langues

eng

Informations de copyright

Copyright © 2023, The Authors.

Auteurs

Maarten Theodoor Homburg (MT)

Department of Department of Primary- and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, Netherlands t.m.homburg@umcg.nl.
ORCID: 0000-0002-3295-4656

Marjolein Berger (M)

Department of Department of Primary- and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.

Matthijs Berends (M)

Department of Department of Primary- and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
Department of Medical Epidemiology, Certe Medical Diagnostics and Advice Foundation, Groningen, Netherlands.

Eline Meijer (E)

Department of Department of Primary- and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
University of Groningen, University Medical Center Groningen, Data Science Center in Health (DASH), Groningen, Netherlands.

Thijmen Kupers (T)

Department of Department of Primary- and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
University of Groningen, University Medical Center Groningen, Data Science Center in Health (DASH), Groningen, Netherlands.

Lotte Ramerman (L)

Nivel, Netherlands Institute for Health Services Research (Nivel), Utrecht, Netherlands.

Corinne Rijpkema (C)

Nivel, Netherlands Institute for Health Services Research (Nivel), Utrecht, Netherlands.

Evelien de Schepper (E)

Department of General Practice, Erasmus Medical Center, Rotterdam, Netherlands.

Tim Olde Hartman (T)

Radboud University Nijmegen Medical Center, Radboud Institute of Health Sciences, Department of Primary and Community Care, Nijmegen, Netherlands.
ORCID: 0000-0003-2078-1206

Jean Muris (J)

Department of Family Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University Medical Center, Maastricht, Netherlands.

Robert Verheij (R)

Nivel, Netherlands Institute for Health Services Research (Nivel), Utrecht, Netherlands.
Tranzo, Department of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands.

Lilian Peters (L)

Department of Department of Primary- and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Midwifery Science, AVAG, Amsterdam Public Health, Amsterdam, Netherlands.

Classifications MeSH