Nivel, Netherlands Institute for Health Services Research, Postbus 1568, Utrecht, 3500 BN, The Netherlands.
Tranzo, Tilburg University, Postbus 90153, Tilburg, 5000 LE, the Netherlands.
BMC Health Serv Res. 2022 May 21;22(1):679. doi: 10.1186/s12913-022-08096-x.
In the Netherlands, General Practitioners (GP) are usually the first point of contact with a health professional for most health problems. Out-of-hours (OOH) primary care is provided by regional OOH services. Changes in consultation rates at OOH services may be regarded as a warning system for failures elsewhere in the healthcare system. Therefore in this study, we investigated how the COVID-19 pandemic changed the use of primary care OOH services during the first year of the pandemic.
Routine electronic health records data were used from 60% of OOH services in the Netherlands, collected by the Nivel Primary Care Database. We compared consultation rates per week (2020) for COVID-19-like symptoms and other health problems (e.g. small traumas, urinary tract infections), for different age groups, the proportion of remote consultations, and different levels of urgency during the pandemic compared to the same period in 2019.
The number of consultations for COVID-19-like symptoms peaked at the start of the COVID-19 pandemic, while consultations for other health problems decreased. These changes in consultation rates differed between age groups. Remote consultations took place more frequently for all health problems, while the proportion of non-urgent health problems increased.
There were significant changes in the number of consultations and the proportion that were remote for COVID-19-like symptoms and other health problems. Especially care for babies and young children decreased, while the number of consultations for older adults remained stable. The continued use of OOH services by older adults suggests there were unmet care needs elsewhere in our healthcare system.
在荷兰，大多数健康问题通常都是由全科医生（GP）作为与健康专业人员联系的第一站。非工作时间（OOH）的初级保健由区域 OOH 服务提供。OOH 服务中咨询率的变化可能被视为医疗保健系统其他地方出现故障的预警系统。因此，在这项研究中，我们调查了 COVID-19 大流行如何在大流行的第一年改变 OOH 初级保健服务的使用情况。
我们使用了荷兰 60%的 OOH 服务的常规电子健康记录数据，这些数据由 Nivel 初级保健数据库收集。我们比较了 COVID-19 样症状和其他健康问题（例如小创伤、尿路感染）的每周咨询率（2020 年），比较了不同年龄组、远程咨询的比例以及大流行期间与 2019 年同期相比不同紧急程度的咨询率。
COVID-19 样症状的咨询量在 COVID-19 大流行开始时达到峰值，而其他健康问题的咨询量则下降。这些咨询率的变化在不同年龄组之间有所不同。所有健康问题的远程咨询都更为频繁，而非紧急健康问题的比例也有所增加。
COVID-19 样症状和其他健康问题的咨询数量和远程咨询的比例都发生了显著变化。特别是对婴儿和幼儿的护理减少了，而老年人的咨询量保持稳定。老年人继续使用 OOH 服务表明我们的医疗保健系统其他地方存在未满足的护理需求。
