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).
oleh: Karen Tu, María C Lapadula, Jemisha Apajee, Angela Ortigoza Bonilla, Valborg Baste, María S Cuba-Fuentes, Simon de Lusignan, Signe Flottorp, Gabriela Gaona, Lay Hoon Goh, Christine M Hallinan, Robert S Kristiansson, Adrian Laughlin, Zhuo Li, Zheng J Ling, Jo-Anne Manski-Nankervis, Amy P P Ng, Luciano F Scattini, Javier Silva-Valencia, Wilson D Pace, Knut-Arne Wensaas, William C W Wong, Paula L Zingoni, John M Westfall, INTRePID
| Format: | Article |
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| Diterbitkan: | Public Library of Science (PLoS) 2024-01-01 |
Deskripsi
<h4>Background</h4>The COVID-19 pandemic has reshaped healthcare delivery worldwide.<h4>Objective</h4>To explore potential changes in the reasons for visits and modality of care in primary care settings through the International Consortium of Primary Care Big Data Researchers (INTRePID).<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>The pandemic resulted in changes in reasons for visits to primary care, with virtual care mitigating visit volume disruptions in many countries.