Effect of the COVID-19 Lockdown on Disease Recognition and Utilization of Healthcare Services in the Older Population in German: A Cross-sectional Study.

Abstract:

BACKGROUND:There is little evidence about the utilization of healthcare services and disease recognition in the older population, which was urged to self-isolate during the COVID-19 lockdowns. OBJECTIVES:We aimed to describe the utilization of physician consultations, specialist referrals, hospital admissions, and the recognition of incident diseases in Germany for this age group during the COVID-19 lockdown. DESIGN:Cross-sectional observational study. SETTING:1,095 general practitioners' (GPs) and 960 specialist practices in Germany. SUBJECTS:2.45 million older patients aged 65 or older. METHODS:The number of documented physician consultations, specialist referrals, hospital admissions, and incident diagnoses during the imposed lockdown in 2020 was descriptively analyzed and compared to 2019. RESULTS:Physician consultations decrease slightly in February (-2%), increase before the imposed lockdown in March (+9%), and decline in April (-18%) and May (-14%) 2020 compared to the same periods in 2019. Volumes of hospital admissions decrease earlier and more intensely than physician consultations (-39% vs. -6% respectively). Overall, 15%, 16%, and 18% fewer incident diagnoses were documented by GPs, neurologists, and diabetologists respectively in 2020. Diabetes, dementia, depression, cancer, and stroke were diagnosed less frequently during the lockdown (-17% to -26%), meaning that the decrease in the recognition of diseases was greater than the decrease in physician consultations. CONCLUSION:The data suggest that organizational changes were adopted quickly by practice management, but also raise concerns about the maintenance of routine care. Prospective studies should evaluate the long-term effects of lockdowns on patient-related outcomes.

journal_name

Age Ageing

journal_title

Age and ageing

authors

Michalowsky B,Hoffmann W,Bohlken J,Kostev K

doi

10.1093/ageing/afaa260

subject

Has Abstract

pub_date

2020-11-17 00:00:00

eissn

0002-0729

issn

1468-2834

pii

5985951

pub_type

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