Abstract
ObjectivesThe aims of our study were to describe the effect of the COVID-19 pandemic and lockdown on primary care in Germany regarding the number of consultations, the prevalence of specific reasons for consultation presented by the patients, and the frequency of specific services performed by the GP.MethodsWe conducted a longitudinal observational study based on standardised GP interviews in a quota sampling design comparing the time before the COVID-19 pandemic (12 June 2015 to 27 April 2017) with the time during lockdown (21 April to 14 July 2020). The sample included GPs in urban and rural areas 120 km around Hamburg, Germany, and was stratified by region type and administrative districts. Differences in the consultation numbers were analysed by multivariate linear regressions in mixed models adjusted for random effects on the levels of the administrative districts and GP practices.ResultsOne hundred ten GPs participated in the follow-up, corresponding to 52.1% of the baseline. Primary care practices in 32 of the 37 selected administrative districts (86.5%) could be represented in both assessments. At baseline, GPs reported 199.6 ± 96.9 consultations per week, which was significantly reduced during COVID-19 lockdown by 49.0% to 101.8 ± 67.6 consultations per week (p < 0.001). During lockdown, the frequency of five reasons for consultation (-43.0% to -31.5%) and eleven services (-56.6% to -33.5%) had significantly decreased. The multilevel, multivariable analyses showed an average reduction of 94.6 consultations per week (p < 0.001).ConclusionsWe observed a dramatic reduction of the number of consultations in primary care. This effect was independent of age, sex and specialty of the GP and independent of the practice location in urban or rural areas. Consultations for complaints like low back pain, gastrointestinal complaints, vertigo or fatigue and services like house calls/calls at nursing homes, wound treatments, pain therapy or screening examinations for the early detection of chronic diseases were particularly affected.
Highlights
The COVID-19 pandemic originated from China and spread across the world during the year 2020
The aims of our study were to describe the effect of the COVID-19 lockdown on primary care in Germany regarding 1) the number of consultations 2) the prevalence of specific reasons for consultation presented by the patients and 3) the frequency of specific services performed by the general practitioner (GP)
GPs reported 199.6 ± 96.9 consultations per week, which was significantly reduced during COVID-19 lockdown by 49.0% to 101.8 ± 67.6 consultations per week (p < 0.001)
Summary
The COVID-19 pandemic originated from China and spread across the world during the year 2020. The lockdown included that – amongst other measures – all schools and facilities for childcare [3], education, sport, recreation and amusement had to close [4], contact restrictions for all people within Germany were decreed [4], planned hospital admissions and operations had to be postponed if medically justifiable [5] and visitations in hospitals and nursing homes were strictly regulated [6]. In the federal state of Lower Saxony, on 6 May, hairdressers and shops with less than 800m2 sales floor were allowed to open under strict regulations, but it was not before 22 June until childcare facilities and schools were opened for all children again [7]
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