Determinants of Outpatient Physician Visits in the General Adult German Population during Later Stages of the COVID-19 Pandemic

Abstract

The goal of this study was to investigate the determinants of outpatient physician visits in Germany during the later stages of the COVID-19 pandemic. Cross-sectional data were used from the general adult population in Germany with n = 3091 individuals (data collection in mid-March 2022). Determinants were selected based on the extended Andersen model. The number of GP visits as well as the number of specialist visits in the past 12 months were used as outcome measures. Negative binomial regressions showed that the number of GP visits was positively associated with a lower educational level, being retired, lower levels of loneliness, the presence of at least one chronic condition, lower self-rated health, being vaccinated against COVID-19, and the presence of depression. Moreover, negative binomial regressions showed that the number of specialist visits was positively associated with being female, a lower age, having children, being married, not being full-time employed, the presence of at least one chronic condition, lower self-rated health, the presence of depression, being vaccinated against COVID-19 and having a lower coronavirus anxiety. In conclusion, while our study showed that need factors are still a main driver of outpatient physician visits, our findings additionally showed that predisposing characteristics, enabling resources and psychosocial factors are also important for the number of outpatient physician visits in Germany during the COVID-19 pandemic. Knowledge about these determinants (e.g., vaccination status, loneliness or coronavirus anxiety) is also important to avoid under- or overuse of the healthcare system.

Outpatient health service utilization among adults with selected chronic diseases during the COVID-19 pandemic in Germany - results of the GEDA studies between 2019 and 2021

“…The average number of GP and specialist visits was found to be 2.6 visits and 2.1 visits in the past 12 months, respectively. This was comparable to ndings before the pandemic [19]. Consistent with our ndings, ACSC outpatient visit rates in a Canadian study decreased initially in wave I (March to May 2020) and then returned to the expected level in Summer Lull 2020 (June to August 2020) and remained similar during wave II (September 2020 to March 2021) [20].…”

“…We found no difference in the utilization of outpatient health care service in the 4th pandemic wave in comparison with pre-pandemic phase, suggesting outpatient health care service returned to the level of the pre-pandemic period. This is supported by ndings of a recent study conducted in March 2022 in Germany [19]. The average number of GP and specialist visits was found to be 2.6 visits and 2.1 visits in the past 12 months, respectively.…”

“…Our own previous studies found a signi cant decrease both in GP and specialist visits in the general population [17] and a signi cant decrease in visits to specialists but not to GPs among people with known diabetes during the rst wave of COVID-19 in 2020 [18]. Although the pandemic has gone through multiple phases worldwide, including Germany, few studies have examined how healthcare utilization developed across different waves of the pandemic and if it returned to the pre-pandemic level in spite of the ongoing pandemic [19][20][21]. This is of particularly concern for people with cardiometabolic diseases [1].…”

Outpatient Health Service Utilization Among Adults with Diabetes, Hypertension and Cardiovascular Disease During the COVID-19 Pandemic – Results of Population-Based Surveys in Germany from 2019 to 2021

“…This is supported by findings of a recent study conducted in March 2022 in Germany. 30 The average number of GP and specialist visits was found to be 2.6 visits and 2.1 visits in the past 12 months, respectively. This was comparable to findings before the pandemic.…”

“… 27–29 So far, few population-based studies have examined how healthcare utilization developed across different waves of the pandemic and if it returned to the pre-pandemic level in spite of the ongoing pandemic. 30–32 …”