Impact of the COVID-19 Pandemic on Consultations and Diagnoses in Gastroenterology Practices in Germany.

Markus S Jördens,Tobias Seraphin,Karel Kostev,Tom Luedde,Christoph Roderburg,Sven H Loosen

doi:10.3389/fmed.2021.684032

Markus S Jördens, Tobias Seraphin + Show 4 more

Open Access

https://doi.org/10.3389/fmed.2021.684032

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Abstract

The COVID-19 pandemic has been a major burden for healthcare systems worldwide and has caused multiple changes and problems in outpatient care. The aim of this study was to investigate the impact of the COVID-19 pandemic on consultations and diagnoses in gastroenterology practices in Germany. To this end, we retrospectively analyzed data from the Disease Analyzer database (IQVIA) using the International Classification of Diseases, 10th revision (ICD-10). We included all patients aged ≥18 years with at least one visit to one of 48 gastroenterology practices in Germany between April and September 2019 and April and September 2020. A total of 63,914 patients in the 2nd quarter of 2019, 63,701 in the 3rd quarter of 2019, 55,769 in the 2nd quarter of 2020, and 60,446 in the 3rd quarter of 2020 were included. Overall, a clear downward trend in the number of visits to gastroenterologists was observed in the 2nd quarter of 2020 compared to 2019 (−13%, p = 0.228). The decrease in consultations was particularly pronounced in patients >70 years of age (−17%, p = 0.096). This trend was evident for all gastrointestinal diagnoses except for tumors. Most notably, rates of gastrointestinal infections (−19%) or ulcers (−43%) were significantly lower in this period than in the same quarter of 2019. Reflecting the course of the pandemic, the differences between the 3rd quarter of 2020 and that of 2019 were less pronounced (−5%, p = 0.560). Our data show that the pandemic changed patients' behavior with respect to the health care system. Using the example of German gastroenterology practices, we show that the number of consultations as well as the number and range of diagnoses have changed compared to the same period in 2019.

Highlights

Since its first description in December 2019, the coronavirus-2 (SARS-CoV-2) severe acute respiratory syndrome, later defined as the coronavirus disease 2019 (COVID-19), has spread around the globe and subsequently induced a severe pandemic often compared to the Spanish Flu at the beginning of the 20th century [1]
The German outpatient care system is built on patient consultations with general practitioners, who refer these patients to a specialist, e.g., a gastroenterologist, if medically indicated [3]
It seems likely that these measures as well as a general fear of becoming infected when using healthcare services have influenced the number and type of visits to physicians. In this retrospective analysis, using data from the Disease Analyzer database (IQVIA), we investigated the impact of the COVID19 pandemic on consultations and diagnoses in gastroenterology practices in Germany

Summary

Introduction

Since its first description in December 2019, the coronavirus-2 (SARS-CoV-2) severe acute respiratory syndrome, later defined as the coronavirus disease 2019 (COVID-19), has spread around the globe and subsequently induced a severe pandemic often compared to the Spanish Flu at the beginning of the 20th century [1]. To prevent healthcare systems and, in particular, intensive care units from becoming overwhelmed by severe cases of COVID-19, governments around the globe implemented a range of non-pharmaceutical measures with different and changing levels of intensity [5]. In the beginning of 2020, the German Federal Government imposed rigorous measures to contain the spread of the virus due to rising infection numbers (Figure 1) [6]. This included, e.g., closures of bars and restaurants, schools and public playgrounds, as well as a recommendation for businesses to allow and facilitate remote working [7]

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