Changes in primary care visits arising from the COVID-19 pandemic: an international comparative study by the International Consortium of Primary Care Big Data Researchers (INTRePID)

• Published in: BMJ open Vol. 12; no. 5; p. e059130
• Main Authors: Tu, Karen, Sarkadi Kristiansson, Robert, Gronsbell, Jessica, de Lusignan, Simon, Flottorp, Signe, Goh, Lay Hoon, Hallinan, Christine Mary, Hoang, Uy, Kang, Seo Young, Kim, Young Sik, Li, Zhou, Ling, Zheng Jye, Manski-Nankervis, Jo-Anne, Ng, Amy Pui Pui, Pace, Wilson D, Wensaas, Knut-Arne, Wong, William CW, Stephenson, Ellen, Lusignan, Simon de, Hallinan, Christine, Kristiansson, Robert Sarkadi
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 09.05.2022; BMJ Publishing Group LTD; BMJ Publishing Group
• Series: Original research
• Subjects: Big Data; Capitation; Chronic illnesses; Clinics; Consortia; COVID-19; COVID-19 - epidemiology; Disease prevention; Disease transmission; Family physicians; Funding; General practice / Family practice; Health care access; Health care delivery; Health care policy; HEALTH SERVICES ADMINISTRATION & MANAGEMENT; Humans; Infectious diseases; Insurance coverage; Pandemics; PRIMARY CARE; Primary Health Care; SARS-CoV-2; State of emergency; Telemedicine; Canada; South Korea; Sweden; Singapore; United Kingdom > UK; United States > US; Norway; China; Australia; COVID-19; HEALTH SERVICES ADMINISTRATION & MANAGEMENT; PRIMARY CARE
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2021-059130

IntroductionThrough the INTernational ConsoRtium of Primary Care BIg Data Researchers (INTRePID), we compared the pandemic impact on the volume of primary care visits and uptake of virtual care in Australia, Canada, China, Norway, Singapore, South Korea, Sweden, the UK and the USA.MethodsVisit definitions were agreed on centrally, implemented locally across the various settings in INTRePID countries, and weekly visit counts were shared centrally for analysis. We evaluated the weekly rate of primary care physician visits during 2019 and 2020. Rate ratios (RRs) of total weekly visit volume and the proportion of weekly visits that were virtual in the pandemic period in 2020 compared with the same prepandemic period in 2019 were calculated.ResultsIn 2019 and 2020, there were 80 889 386 primary care physician visits across INTRePID. During the pandemic, average weekly visit volume dropped in China, Singapore, South Korea, and the USA but was stable overall in Australia (RR 0.98 (95% CI 0.92 to 1.05, p=0.59)), Canada (RR 0.96 (95% CI 0.89 to 1.03, p=0.24)), Norway (RR 1.01 (95% CI 0.88 to 1.17, p=0.85)), Sweden (RR 0.91 (95% CI 0.79 to 1.06, p=0.22)) and the UK (RR 0.86 (95% CI 0.72 to 1.03, p=0.11)). In countries that had negligible virtual care prepandemic, the proportion of visits that were virtual were highest in Canada (77.0%) and Australia (41.8%). In Norway (RR 8.23 (95% CI 5.30 to 12.78, p<0.001), the UK (RR 2.36 (95% CI 2.24 to 2.50, p<0.001)) and Sweden (RR 1.33 (95% CI 1.17 to 1.50, p<0.001)) where virtual visits existed prepandemic, it increased significantly during the pandemic.ConclusionsThe drop in primary care in-person visits during the pandemic was a global phenomenon across INTRePID countries. In several countries, primary care shifted to virtual visits mitigating the drop in in-person visits.