Dale Jonas Nordvik, Morken Tone, Eliassen Knut Eirik, Blinkenberg Jesper, Rortveit Guri, Baste Valborg
National Centre for Emergency Primary Health Care, NORCE Norwegian Research Centre, Bergen, Norway.
Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Scand J Prim Health Care. 2025 Sep;43(3):660-671. doi: 10.1080/02813432.2025.2491762. Epub 2025 Apr 21.
BACKGROUND: Disease prevention strategies during the COVID-19 pandemic could potentially disrupt the continuity of care. Aims: (1) describe changes in contacts with general practitioner (GP) before and during the pandemic, (2) compare consultation rates for common and at-risk diagnoses, and (3) examine the impact of COVID-19 restrictions on monthly consultation rates across patient subgroups. METHODS: Register study with data from the Norwegian Registry for Primary Health Care (NRPHC) for the period 1 April 2018 to 30 March 2021. Changes in consultation rate were the main outcome. Twenty-five diagnoses representing common and at-risk for mortality diagnoses were studied. Interrupted time series analyses were applied. RESULTS: Face-to-face consultations decreased from 2935 to 2304 per 1000 inhabitants per year from the pre-pandemic period to the first pandemic year, with an increase in e-consultations from 60 to 846 per 1000 inhabitants per year. Consultations for common diagnoses decreased by 25.6%, whereas those for high-risk diagnoses decreased by 10.7%. In the group of common diagnoses, the decrease in average monthly consultation rates was less among the eldest compared to the youngest age group. A similar decrease was found in the group with multiple morbid conditions compared to single or no morbidity. CONCLUSIONS: The pandemic resulted in fewer face-to-face consultations, but there was a substantial rise in electronic consultations. Consultations for at-risk for mortality diagnoses decreased relatively less than for common diagnoses. Consultation rates for older adults and those with multiple decreased less, suggesting that sicker patients continued to visit their GP during the pandemic.
背景:2019年冠状病毒病(COVID-19)大流行期间的疾病预防策略可能会扰乱医疗服务的连续性。目的:(1)描述大流行之前和期间与全科医生(GP)接触的变化,(2)比较常见诊断和高危诊断的会诊率,以及(3)研究COVID-19限制措施对各患者亚组每月会诊率的影响。 方法:采用登记研究,数据来自挪威初级卫生保健登记处(NRPHC),时间跨度为2018年4月1日至2021年3月31日。会诊率的变化是主要结果。研究了代表常见诊断和死亡高危诊断的25种诊断。应用了中断时间序列分析。 结果:从大流行前时期到第一个大流行年份,面对面会诊从每年每1000名居民2935次降至2304次,电子会诊从每年每1000名居民60次增至846次。常见诊断的会诊减少了25.6%,而高危诊断的会诊减少了10.7%。在常见诊断组中,与最年轻年龄组相比,最年长者的平均每月会诊率下降幅度较小。与单一疾病或无疾病组相比,患有多种疾病的组也有类似程度的下降。 结论:大流行导致面对面会诊减少,但电子会诊大幅增加。死亡高危诊断的会诊减少幅度相对小于常见诊断。老年人和患有多种疾病者的会诊率下降幅度较小,这表明病情较重的患者在大流行期间仍继续就诊于全科医生。
Cochrane Database Syst Rev. 2024-5-2
Cochrane Database Syst Rev. 2023-1-30
Cochrane Database Syst Rev. 2022-11-17
Cochrane Database Syst Rev. 2022-1-17
J Adv Nurs. 2024-3
JMIR Public Health Surveill. 2023-5-2
Br J Gen Pract. 2022-11