Beyond the pandemic: rising administrative demands and changing disease profiles in primary care.

Abstract

Background: The COVID-19 pandemic has transformed healthcare, affecting the diagnosis and management of common diseases. Our study aimed to assess the effect of the changes in reasons for primary care visits on primary care physicians' (PCPs') workload from 2019 to 2023, focusing on non-COVID-related diseases.

Methods: A cross-sectional study of electronic medical records conducted at Leumit Health Services between 2019 and 2023, approximately 510,000 patients who had at least one consultation with a PCP were included. The study categorized visits using ICD-9 codes and calculated the number of visits and the accumulated annual duration of time (AADT) for each code group.

Results: In 2023, there was a significant 38.9% increase in administrative visits compared to 2019, with these visits accounting for 21.8% of AADT. Additionally, a consistent rise in visits for hyperlipidemia, obesity, and diabetes was noted. Conversely, the AADT for respiratory tract infections and sexually transmitted diseases markedly declined. A lesser, yet still notable, decrease was observed in other infectious diseases, injuries, heart diseases, and pulmonary diseases.

Conclusions: COVID-19 altered the distribution of primary care visit reasons and subsequently impacted the burden on PCPs. Notably, there was an increase in visits for bureaucratic issues and a concerning reduction in follow-ups for cardiovascular risk factors, alongside a rise in metabolic conditions. These trends persisted even after the pandemic waned, despite the removal of social restrictions. Policymakers should evaluate how to optimize the utilization of PCPs' time and explore methods to regulate demand for improved efficiency.