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)

Datos Bibliográficos

ID19592027
AutoresKaren Tu (0000-0003-0883-4934, University Health Network, autor de correspondencia), María C Lapadula (0000-0001-5156-121X, University of Toronto, autor de correspondencia), Jemisha Apajee (University of Toronto, autor de correspondencia), Angela Ortigoza Bonilla (University of Toronto, autor de correspondencia), Valborg Baste (0000-0001-6640-9747, NORCE Research AS, autor de correspondencia), Maria Sofia Cuba-Fuentes (0000-0001-7394-7092, Universidad Peruana Cayetano Heredia, autor de correspondencia), Simon De Lusignan (0000-0002-8553-2641, University of Oxford, autor de correspondencia), Signe Flottorp (0000-0003-2961-7461, Norwegian Institute of Public Health, autor de correspondencia), Gabriela Gaona (0009-0003-6767-4819, autor de correspondencia), Lay Hoon Goh (0000-0003-1536-3050, National University of Singapore, autor de correspondencia), Christine Mary Hallinan (0000-0002-0471-4444, The University of Melbourne, autor de correspondencia), Robert Kristiansson (0000-0002-3036-1048, Uppsala University, autor de correspondencia), Robert S Kristiansson, Adrian Laughlin (0000-0003-3545-4785, The University of Melbourne, autor de correspondencia), Zhuo Li (0000-0002-8184-6678, University of Hong Kong - Shenzhen Hospital, autor de correspondencia), Zheng J Ling (0000-0001-9584-4473, National University of Singapore, autor de correspondencia), Jo‐Anne E Manski‐Nankervis (0000-0003-2153-3482, The University of Melbourne, autor de correspondencia), Amy P P Ng (0000-0003-3867-6447, Chinese University of Hong Kong, autor de correspondencia), Luciano F Scattini (autor de correspondencia), Javier Silva-Valencia (0000-0002-5982-2821, North York General Hospital, autor de correspondencia), Wilson D Pace (0000-0003-1699-5471, autor de correspondencia), Knut-Arne Wensaas, Knut‐Arne Wensaas (0000-0001-9113-7843, NORCE Research AS, autor de correspondencia), William Chi-Wai Wong (0000-0003-2540-4055, Chinese University of Hong Kong, autor de correspondencia), William C W Wong, Paula L Zingoni, Paula Zingoni (autor de correspondencia), John M Westfall (0000-0002-1070-0268, autor de correspondencia), on behalf of INTRePID
EditoresHannah Hogan Leslie
Año2024
Volumen4
Número8
Páginase0003406
Fecha de publicación2024-08-22
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaPLOS Global Public Health (JOURNAL)
Identificadores de la revistaISSN: 2767-3375 • E-ISSN: 2767-3375
EditorialPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0003406
PMID39173045
OpenAlexW4401746398
IdiomaEN
Referencias citadas26

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