Abstract
Objectives: We aimed to explore the impact of the Swiss shutdown in spring 2020 on the intensity of health services use in general practice. Methods: Based on an electronic medical records database, we built one patient cohort each for January-June 2019 (control, 173,523 patients) and 2020 (179,086 patients). We used linear regression to model weekly consultation counts and blood pressure (BP) and glycated hemoglobin (HbA1c) measurement counts per 100 patients and predicted non-shutdown values. Analyses were repeated for selected at-risk groups and different age groups. Results: During the shutdown, weekly consultation counts were lower than predicted by −17.2% (total population), −16.5% (patients with hypertension), −17.5% (diabetes), −17.6% (cardiovascular disease), −15.7% (patients aged <60 years), −20.4% (60–80 years), and −14.5% (>80 years). Weekly BP counts were reduced by −35.3% (total population) and −35.0% (hypertension), and HbA1c counts by −33.2% (total population) and −29.8% (diabetes). p-values <0.001 for all reported estimates. Conclusion: Our results document consequential decreases in consultation counts and chronic disease monitoring during the shutdown. It is crucial that health systems remain able to meet non-COVID-19-related health care needs.
Highlights
When the first wave of the current coronavirus disease 19 (COVID-19) pandemic swept throughout the world in spring 2020, many countries introduced mitigation measures aiming to combat the spread of the novel virus (SARS-CoV-2)
We aimed to explore the impact of the COVID-19 pandemic on the intensity of health care use in general practice by investigating trends in weekly consultation- and chronic disease measurement counts for the total general practice population and for different at-risk patient groups and different age groups
Despite several population groups being at high risk for severe COVID-19, in this study, we focused on patients with diabetes, hypertension and cardiovascular disease (CVD), because patients living with these conditions require regular care commonly provided in general practice, and because they are among the most common chronic conditions in Switzerland5
Summary
When the first wave of the current coronavirus disease 19 (COVID-19) pandemic swept throughout the world in spring 2020, many countries introduced mitigation measures aiming to combat the spread of the novel virus (SARS-CoV-2). Whereas the public health focus has justifiably attended to immediate threats posed by SARS-CoV-2, the pandemic is likely to have had an impact on patients and their health services use with regard to non-COVID-19 conditions and regular care, especially in general practice. From 16 March 2020 to 26 April 2020, all non-urgent treatments and consultations were banned in order to free up consultation hours in the expectation of a high workload from COVID-19 positive patients. From 16 March 2020 to 26 April 2020, all non-urgent treatments and consultations were banned in order to free up consultation hours in the expectation of a high workload from COVID-19 positive patients2 When this ban was in place, health care professionals expressed concerns that patients would avoid contacting the health care system for what would be considered urgent. Patients might have been afraid of getting infected with COVID-19 at the doctor’s office, even after the ban was lifted
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