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Observational Study
. 2021 Feb 26;50(2):317-325.
doi: 10.1093/ageing/afaa260.

Effect of the COVID-19 lockdown on disease recognition and utilisation of healthcare services in the older population in Germany: a cross-sectional study

Bernhard Michalowsky  1 , Wolfgang Hoffmann  1   2 , Jens Bohlken  3 , Karel Kostev  4
Affiliations
Observational Study

Effect of the COVID-19 lockdown on disease recognition and utilisation of healthcare services in the older population in Germany: a cross-sectional study

Bernhard Michalowsky et al. Age Ageing. .

Abstract

Background: There is little evidence about the utilisation of healthcare services and disease recognition in the older population, which was urged to self-isolate during the COVID-19 lockdown.

Objectives: We aimed to describe the utilisation 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 analysed 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 versus -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 organisational 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.

Keywords: COVID-19; healthcare utilisation; lockdown; older people; recognition.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Timeline of COVID-19-related recommendations and measures in Germany.
Figure 2
Figure 2
Overview of healthcare services utilised and incident diseases detected during the COVID-19 pandemic in Germany in 2020 compared to 2019.
See this image and copyright information in PMC

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