Changes in reasons for visits to primary care after the start of the Covid-19 pandemic

An international comparative study by the International Consortium of Primary Care Big Data Researchers (INTRePID)

Bibliographic Data

ID19592027
AuthorsKaren Tu (0000-0003-0883-4934, University Health Network, corresponding author), María C Lapadula (0000-0001-5156-121X, University of Toronto, corresponding author), Jemisha Apajee (University of Toronto, corresponding author), Angela Ortigoza Bonilla (University of Toronto, corresponding author), Valborg Baste (0000-0001-6640-9747, NORCE Research AS, corresponding author), Maria Sofia Cuba-Fuentes (0000-0001-7394-7092, Universidad Peruana Cayetano Heredia, corresponding author), Simon De Lusignan (0000-0002-8553-2641, University of Oxford, corresponding author), Signe Flottorp (0000-0003-2961-7461, Norwegian Institute of Public Health, corresponding author), Gabriela Gaona (0009-0003-6767-4819, corresponding author), Lay Hoon Goh (0000-0003-1536-3050, National University of Singapore, corresponding author), Christine Mary Hallinan (0000-0002-0471-4444, The University of Melbourne, corresponding author), Robert Kristiansson (0000-0002-3036-1048, Uppsala University, corresponding author), Robert S Kristiansson, Adrian Laughlin (0000-0003-3545-4785, The University of Melbourne, corresponding author), Zhuo Li (0000-0002-8184-6678, University of Hong Kong - Shenzhen Hospital, corresponding author), Zheng J Ling (0000-0001-9584-4473, National University of Singapore, corresponding author), Jo‐Anne E Manski‐Nankervis (0000-0003-2153-3482, The University of Melbourne, corresponding author), Amy P P Ng (0000-0003-3867-6447, Chinese University of Hong Kong, corresponding author), Luciano F Scattini (corresponding author), Javier Silva-Valencia (0000-0002-5982-2821, North York General Hospital, corresponding author), Wilson D Pace (0000-0003-1699-5471, corresponding author), Knut-Arne Wensaas, Knut‐Arne Wensaas (0000-0001-9113-7843, NORCE Research AS, corresponding author), William Chi-Wai Wong (0000-0003-2540-4055, Chinese University of Hong Kong, corresponding author), William C W Wong, Paula L Zingoni, Paula Zingoni (corresponding author), John M Westfall (0000-0002-1070-0268, corresponding author), on behalf of INTRePID
EditorsHannah Hogan Leslie
Year2024
Volume4
Issue8
Pagese0003406
Publication date2024-08-22
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0003406
PMID39173045
OpenAlexW4401746398
LanguageEN
References cited26

Background The COVID-19 pandemic has reshaped healthcare delivery worldwide. Objective To explore potential changes in the reasons for visits and modality of care in primary care settings through the Int ernational Conso r tium of P rimary Care B i g D ata Researchers (INTRePID). Methods We conducted a cross-sectional, retrospective study from 2018–2021. We examined visit volume, modality, and reasons for visits to primary care in Argentina, Australia, Canada, China, Peru, Norway, Singapore, Sweden, and the USA. The analysis involved a comparison between the pre-pandemic and pandemic periods. Results There were more than 215 million visits from over 38 million patients during the study period in INTRePID primary care settings. Most INTRePID countries experienced a decline in monthly visit rates during the first year of the pandemic, with rate ratios (RR) and 95% confidence intervals (CI) ranging from RR:0.57 (95%CI:0.49–0.66) to RR:0.90 (95%CI:0.83–0.98), except for in Canada (RR:0.99, 95%CI:0.94–1.05) and Norway (RR:1.00, 95%CI:0.92–1.10), where rates remained stable and in Australia where rates increased (RR:1.19, 95%CI:1.11–1.28). Argentina, China, and Singapore had limited or no adoption of virtual care, whereas the remaining INTRePID countries varied in the extent of virtual care utilization. In Peru, virtual visits accounted for 7.34% (95%CI:7.33%-7.35%) of all interactions in the initial year of the pandemic, dipping to 5.22% (95%CI:5.21%-5.23%) in the subsequent year. However, in Canada 75.30% (95%CI:75.20%-75.40%) of the visits in the first year were virtual, decreasing to 62.77% (95%CI:62.66%-62.88%) in the second year. Diabetes, hypertension and/or hyperlipidemia and general health exams were in the top 10 reasons for visits in 2019 for all countries. Anxiety, depression and/or other mental health related reasons were among the top 10 reasons for virtual visits in all countries that had virtual care. Conclusions The pandemic resulted in changes in reasons for visits to primary care, with virtual care mitigating visit volume disruptions in many countries

China · Confidence interval · Disease · Family medicine · Geography · Health care · Pandemic · Political science · Primary care · COVID-19 and healthcare impacts · Demography · Medicine · Primary Care and Health Outcomes · Telemedicine and Telehealth Implementation · Internal Medicine · Pediatrics