Changes in the use and organization of care in general practices and out-of-hours services: lessons learned from the COVID-19 pandemic

The outbreak of the COVID-19 pandemic had a major impact on care provided by the GP or the GP post. In the COVID-GP project, we investigated the consequences for healthcare use and the organization of GP care using 1) data from the electronic patient records of the GP or GP post, 2) questionnaires from the Nivel Corona cohort and 3) interviews with patients and healthcare professionals. In the first phase of the pandemic, there was a significant decrease in care provided by the GP and some care was provided remotely. Despite positive experiences with accessibility (longer consultations, less crowds in the waiting room) and effectiveness (limiting patient flows through triage (medical and non-medical rules that teams of healthcare providers must follow when making such a choice, this is called "triage") and remote care), healthcare use increased again over time/the pandemic and consultations were more often scheduled in the GP practice again. More research is needed to find out what the long-term effects are of postponed or missed GP care and how the solutions in the pandemic can also contribute to reducing the pressure on GP care outside a pandemic. Objective The overarching goal of the project is to gain insight into the impact of COVID-19 measures on healthcare use and organisation of care in GP practices and HAP and the experiences of patients and professionals. Research design The research is a collaboration between Nivel and the UMCG. Routine care data from the electronic patient files of GP practices and HAP are analysed to map healthcare use. These will be related, with specific attention to vulnerable groups in our society, to: Organisational changes Experiences of patients and healthcare professionals obtained from interviews Questionnaires and data on the use of Thuisarts.nl First results The first results of this research can be found published in March 2021. This concerns reduced healthcare use in 2020 for non-COVID-19 associated care, except for the elderly. These are the key points of the article: During spring and autumn, healthcare use at the GP post for non-COVID-19 associated health problems was significantly lower, compared to before the corona pandemic. In the summer, healthcare use was comparable to 2019. Among the elderly (≥70 years), there was no decrease in healthcare use at the GP post for non-COVID-19 associated health problems during the corona period of 2020. There was an increase in contacts with the GP post related to (inspections at) death/death and dyspnea/shortness of breath attributed to the airways for the elderly (≥70 years). The article can be read on the Nivel website. Furthermore, a quarterly report has been made on decreased healthcare use by pregnant women and women who have just given birth. A report on healthcare use among COPD and asthma patients will follow soon.