Pandemic trends in health care use: From the hospital bed to the general practitioner with COVID-19

Aim To explore whether the acute 30-day burden of COVID-19 on health care use has changed from the beginning to the end of the pandemic. Methods In all Norwegians (N=122 699) who tested positive for SARS-CoV-2 in three pandemic waves (March 1 st -July 31 st 2020 (1 st wave), August 1 st -December 31 st 2020 (2 nd wave), and January 1 st -May 31 st 2021 (3 rd wave)), we studied the age- and sex-specific share of patients (by age groups 1-19, 20-67, and 68 or more) who had: 1) Relied on self-care, 2) used primary care, and 3) used specialist care. Results We find that a remarkably high and stable share (70-80%) of patients with COVID-19 exclusively had contact with primary care in the acute phase, both in the 1 st , 2 nd and 3 rd wave. The mean number of primary care visits ranged between 2 and 4. We also show that the use of specialist care in the acute 30-day phase of COVID-19 has decreased, from 14% being hospitalized at least once during spring 2020, to 4% during spring 2021. The mean number of hospital bed-days decreased significantly for men from the 1 st to the 2 nd wave (from 13 days, 95% CI=11.5-14.5 to 10 days (9-11) for men aged ≥68 years, and from 11 days (10-12) to 9 days (8-10) for men aged 20-67 years), but not for women. Conclusion COVID-19 places a continued high demand on the primary care services, and a decreasing demand on the specialist care services.