Changes in General Practice use and costs with COVID-19 and telehealth initiatives

Abstract

Background: In response to the COVID-19 pandemic, general practice in Australia underwent a rapid transition, including the rollout of population-wide telehealth, with uncertain impacts on general practitioner (GP) use and costs. Aim: To describe how use and costs of GP services changed in 2020—following the pandemic and introduction of telehealth—compared to 2019, and how this varied across population subgroups. Design and setting: Whole-of-population linked-data analysis, Australia. Method: Multi-Agency Data Integration Project data for ~19M individuals from Census 2016 were linked to Medicare data for 2019-2020. We used regression models to compare age-sex-adjusted GP use and out-of-pocket costs (OPCs) over time, overall and by sociodemographic characteristics. Results: 86% of the population visited a GP in Q2-Q4 2020 compared to 90% in Q2-Q4 2019. The mean number of face-to-face GP services per quarter declined, while telehealth services increased, with overall use of GP services in Q4 2020 similar to or higher than Q4 2019. The proportion of total GP services by telehealth stabilised at ~25% in Q4 2020. However, individuals aged 3-14 or ≥70 years and those with limited English proficiency used fewer GP services in 2020 compared to 2019, with a lower proportion by telehealth. Mean OPC-per-service was lower across all subgroups in 2020 compared to 2019. Conclusion: Introduction of widespread telehealth maintained use of GP services during the pandemic and minimised OPCs, but not for all population subgroups. This may reflect technological, social or other barriers to telehealth in these populations, as well as pandemic-related changes in healthcare use.