Nielsen Jesper Bo, Andersen Helene Støttrup
Research Unit for General Practice, University of Southern Denmark Faculty of Health Sciences, Odense, Syddanmark, Denmark
Research Unit for General Practice, Department of Public Health, University of Southern Denmark Faculty of Health Sciences, Odense, Syddanmark, Denmark.
BMJ Open. 2025 Jun 4;15(6):e096243. doi: 10.1136/bmjopen-2024-096243.
The COVID-19 pandemic induced significant changes in access policies to general practice (GP) in most countries. This study aimed to compare and discuss changes in the diagnostic patterns and GP procedures before and during the pandemic.
A register study including data from 11 Danish GP clinics.
Enlisted patients from GP followed 1 year before (February 2019 to January 2020; n=48 650) and 1 year during (April 2020 to March 2021; n=47 207) the COVID-19 pandemic.
Diagnostic patterns, consultation type (face-to-face, email and phone), contact persons (GP or GP staff) and patient characteristics.
The average number of contacts with GP increased from 6.3 contacts per year per patient before the pandemic to 8.3 annual contacts during the pandemic (p<0.01). The proportion of contacts handled face-to-face remained around 53%; however, email contacts more than doubled in number and reached 26% of all contacts during the pandemic. Before the pandemic, GPs handled 36% of all patient contacts. This decreased to 22% during the pandemic, and for some diagnostic groups, the GP staff now handled 90% of the patients. The reduced GP contacts were mainly in email and phone contacts, whereas face-to-face consultations by the GPs seem to have been given priority. No reduction was observed in the absolute number of contacts with diagnoses related to the cardiovascular system or diabetes type 2; however, the proportion of contacts related to skin diseases, upper/lower airway symptoms and preventive care consultations was reduced (p<0.01).
Although these findings cannot prove causality, they demonstrate significant changes in diagnostic patterns, balance between different contact types, and responsible contact persons during the pandemic. Changes mean that it has become a significantly different product that GPs offer their patients. The coming years will show whether these changes remain, whether the quality of treatment and care is the same and whether the changed balance in patient handling (GP or GP staff) is experienced as beneficial by the patients.
新冠疫情在多数国家引发了全科医疗（GP）就诊政策的重大变化。本研究旨在比较和探讨疫情前及疫情期间诊断模式和全科医疗程序的变化。
一项登记研究，纳入了来自丹麦11家全科医疗诊所的数据。
新冠疫情前1年（2019年2月至2020年1月；n = 48650）及疫情期间1年（2020年4月至2021年3月；n = 47207）在全科医疗诊所登记的患者。
诊断模式、会诊类型（面对面、电子邮件和电话）、联系人（全科医生或全科医生工作人员）及患者特征。
疫情前每位患者每年与全科医生的平均接触次数为6.3次，疫情期间增至每年8.3次（p<0.01）。面对面处理的接触比例保持在53%左右；然而，电子邮件接触数量增加了一倍多，在疫情期间达到所有接触的26%。疫情前，全科医生处理了所有患者接触的36%。疫情期间这一比例降至22%，对于某些诊断组，现在全科医生工作人员处理了90%的患者。全科医生接触减少主要体现在电子邮件和电话接触方面，而全科医生的面对面会诊似乎得到了优先处理。与心血管系统疾病或2型糖尿病相关诊断的接触绝对数量未减少；然而，与皮肤病、上/下呼吸道症状及预防性保健会诊相关的接触比例降低了（p<0.01）。
尽管这些发现无法证明因果关系，但它们表明疫情期间诊断模式、不同接触类型之间的平衡以及负责的联系人发生了重大变化。这些变化意味着全科医生为患者提供的服务已显著不同。未来几年将表明这些变化是否持续、治疗和护理质量是否相同以及患者处理方式的变化（全科医生或全科医生工作人员）是否对患者有益。
