BJGP Open (Jul 2024)

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

  • Maarten Homburg,
  • Marjolein Berger,
  • Matthijs Berends,
  • Eline Meijer,
  • Thijmen Kupers,
  • Lotte Ramerman,
  • Corinne Rijpkema,
  • Evelien de Schepper,
  • Tim olde Hartman,
  • Jean Muris,
  • Robert Verheij,
  • Lilian Peters

DOI
https://doi.org/10.3399/BJGPO.2023.0121
Journal volume & issue
Vol. 8, no. 2

Abstract

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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 & setting: Population-based cohort study using electronic health records. The study was undertaken in Dutch general practices involved in regional research networks. Method: An interrupted time-series analysis of changes in healthcare consumption from before to during the pandemic was performed. Descriptive statistics were used on the number of potential COVID-19-related contacts, reason for contact, and type of contact. Results: The study covered 3 595 802 contacts (425 639 patients), 3 506 637 contacts (433 340 patients), and 4 105 413 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. Conclusion: 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.

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