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Dutch GP healthcare consumption in COVID-19 heterogeneous regions: an interregional time-series approach in 2020-2021.

Homburg, M.T., Berger, M., Berends, M., Meijer, E., Kupers, T., Ramerman, L., Rijpkema, C., Schepper, E. de, Olde Hartman, T., Muris, J., Verheij, R., Peters, L. Dutch GP healthcare consumption in COVID-19 heterogeneous regions: an interregional time-series approach in 2020-2021. BJGP Open: 2024, 8(2)
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Background
Many countries observed a sharp decline in the use of general practice services after the outbreak of the COVID-19 pandemic. However, research has not yet considered how changes in healthcare consumption varied among regions with the same restrictive measures but different COVID-19 prevalence.

Aim
To investigate how the COVID-19 pandemic affected healthcare consumption in Dutch general practice during 2020 and 2021, among regions with known heterogeneity in COVID-19 prevalence, from a pre-pandemic baseline in 2019.

Design
Population-based cohort study using electronic health records.

Setting
Dutch general practices involved in regional research networks.

Methods
Interrupted time-series analysis of changes in healthcare consumption from before to during the pandemic. Descriptive statistics on the number of potential COVID-19 related contacts, reason for contact and type of contact.

Results
The study covered 3 627 597 contacts (425 639 patients), 3 532 693 contacts (433 340 patients), and 4 134 636 contacts (434 872 patients) in 2019, 2020, and 2021, respectively. Time-series analysis revealed a significant decrease in healthcare consumption after the outbreak of the pandemic. Despite interregional heterogeneity in COVID-19 prevalence, healthcare consumption decreased comparably over time in the three regions, before rebounding to a level significantly higher than baseline in 2021. Physical consultations transitioned to phone or digital over time.

Conclusions
Healthcare consumption decreased irrespective of the regional prevalence of COVID-19 from the start of the pandemic, with the Delta variant triggering a further decrease. Overall, changes in care consumption appeared to reflect contextual factors and societal restrictions rather than infection rates.