Background
Methods
Study design and population
Statistical analysis
Results
Descriptives
February 2018 | February 2020 | April 2020 | March 2021 | |||||
---|---|---|---|---|---|---|---|---|
Total, % | Consultation rate per 1000 patients | Total, % | Consultation rate per 1000 patients | Total, % | Consultation rate per 1000 patients | Total, % | Consultation rate per 1000 patients | |
Registered patients | 349,800 | NA | 364,917 | NA | 362,241 | NA | 353,233 | NA |
Total consultations (excluding admin) | 123,157 | 352.1 | 141,414 | 387.5 | 108,424 | 299.3 | 199,846 | 565.8 |
GP face-to-face | 62,504, 50.8% | 178.7 | 69,921, 49.4% | 191.6 | 26,009, 24% | 71.8 | 63,042, 31.5% | 178.5 |
GP telephone | 26,540, 21.5% | 75.9 | 25,767, 18.2% | 70.6 | 54,072, 49.9% | 149.3 | 72,704, 36.4% | 205.8 |
GP home | 1127, 0.9% | 3.2 | 1120, 0.8% | 3.1 | 354, 0.3% | 1.0 | 528, 0.3% | 1.5 |
GP electronic | 88, 0.1% | 0.3 | 121, 0.1% | 0.3 | 384, 0.4% | 1.1 | 2569, 1.3% | 7.3 |
Nurse face-to-face | 17,712, 14.4% | 50.6 | 18,842, 13.3% | 51.6 | 6681, 6.2% | 18.4 | 15,811, 7.9% | 44.8 |
Nurse telephone | 972, 0.8% | 2.8 | 1193, 0.8% | 3.3 | 5027, 4.6% | 13.9 | 3267, 1.6% | 9.2 |
Nurse home | 154, 0.1% | 0.4 | 203, 0.1% | 0.6 | 72, 0.1% | 0.2 | 187, 0.1% | 0.5 |
Nurse electronic | 0, 0% | 0.0 | 4, 0% | 0.0 | 3, 0% | 0.0 | 21, 0% | 0.1 |
Other face-to-face | 10,004, 8.1% | 28.6 | 17,686, 12.5% | 48.5 | 8877, 8.2% | 24.5 | 26,168, 13.1% | 74.1 |
Other telephone | 3929, 3.2% | 11.2 | 6455, 4.6% | 17.7 | 6658, 6.1% | 18.4 | 9665, 4.8% | 27.4 |
Other home | 96, 0.1% | 0.3 | 92, 0.1% | 0.3 | 49, 0% | 0.1 | 88, 0% | 0.2 |
Other electronic | 31, 0% | 0.1 | 10, 0% | 0.0 | 238, 0.2% | 0.7 | 5796, 2.9% | 16.4 |
Administrative | 15,827 | 45.2 | 24,876 | 68.2 | 18,365 | 50.7 | 65,242 | 184.7 |
Total consultations for individuals without MM | 58,644, 47.6% | 223.5 | 68,997, 48.8% | 248.6 | 46,487, 42.9% | 168.9 | 102,121, 51.1% | 379.8 |
Total consultations for individuals with MM | 64,513, 52.4% | 738.3 | 72,417, 51.2% | 828.5 | 61,937, 57.1% | 712.4 | 97,725, 48.9% | 1158.5 |
Main results
Without multimorbidity (baseline) | With multimorbidity | ||
---|---|---|---|
Consultation rate | Relative ratea | ||
Feb-20 | 223.1 (220.6–225.6) | 879.4 (868.6–890.3) | 3.94 |
Mar-20 (Start of Pandemic) | 207.8 (205.3–210.3) | 881.8 (869.9–893.7) | 4.24 |
Apr-20 | 179.9 (177.8–182) | 751.5 (741.8–761.3) | 4.18 |
May-20 | 183.6 (181.5–185.7) | 768.6 (759–778.2) | 4.19 |
Jun-20 | 201.7 (199.4–203.9) | 816.3 (806.3–826.3) | 4.05 |
Jul-20 | 231.5 (228.9–234) | 947.6 (936.3–958.9) | 4.09 |
Aug-20 | 220.2 (217.8–222.7) | 854.4 (844.3–864.6) | 3.88 |
Sep-20 | 245.7 (243–248.3) | 967 (955.7–978.3) | 3.94 |
Oct-20 | 290.9 (287.7–294.1) | 1157.4 (1143.8–1171) | 3.98 |
Nov-20 | 274 (271–277) | 1051.1 (1038.5–1063.6) | 3.84 |
Dec-20 | 236.6 (233.9–239.3) | 908.2 (897.1–919.3) | 3.84 |
Jan-21 | 289.8 (286.6–293.1) | 1165 (1150.5–1179.6) | 4.02 |
Feb-21 | 278.9 (275.7–282.1) | 1059.3 (1045.6–1072.9) | 3.80 |
Mar-21 | 334.7 (330.7–338.7) | 1268.3 (1251.2–1285.4) | 3.79 |
White—baseline | Black | Asian | Mixed | Other | Unknown | Missing | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Consultation rate | Relative ratea | Consultation rate | Relative ratea | Consultation rate | Relative ratea | Consultation rate | Relative ratea | Consultation rate | Relative ratea | Consultation rate | Relative ratea | ||
Feb-20 | 759.6 (747.7–771.5) | 887.5 (872.4–902.6) | 1.17 | 890.2 (869.4–911.1) | 1.17 | 800.4 (779–821.7) | 1.05 | 819.4 (791.4–847.3) | 1.08 | 704.4 (674–734.9) | 0.93 | 577.2 (560.6–593.9) | 0.76 |
Mar-20 | 766.1 (753.2–778.9) | 880.9 (864.4–897.4) | 1.15 | 888.6 (863.3–913.8) | 1.16 | 821.7 (794.6–848.8) | 1.07 | 813.1 (777.9–848.4) | 1.06 | 739.8 (698.8–780.8) | 0.97 | 553.9 (533.8–574.1) | 0.72 |
Apr-20 | 678.1 (667.1–689.1) | 786.8 (772.7–800.9) | 1.16 | 783.1 (762.7–803.5) | 1.15 | 717.1 (695.6–738.6) | 1.06 | 733 (704.4–761.6) | 1.08 | 671.5 (638.3–704.8) | 0.99 | 503.2 (486.7–519.7) | 0.74 |
May-20 | 695.8 (684.7–706.8) | 810.3 (796.3–824.2) | 1.16 | 795.4 (776.3–814.5) | 1.14 | 740.2 (720–760.4) | 1.06 | 721.3 (696.1–746.5) | 1.04 | 693.3 (662.8–723.8) | 1.00 | 511.4 (496.2–526.5) | 0.73 |
Jun-20 | 741.4 (729.9–753) | 860.9 (846.5–875.3) | 1.16 | 855.9 (836.9–874.9) | 1.15 | 790.9 (771.2–810.6) | 1.07 | 774.4 (750–798.7) | 1.04 | 750.7 (721.2–780.2) | 1.01 | 547.7 (533–562.3) | 0.74 |
Jul-20 | 842.5 (829.6–855.5) | 1000.4 (984.1–1016.7) | 1.19 | 1006.3 (985.3–1027.3) | 1.19 | 907.6 (886.7–928.4) | 1.08 | 909.1 (883.1–935.1) | 1.08 | 811.6 (783–840.3) | 0.96 | 632.7 (617.2–648.3) | 0.75 |
Aug-20 | 758.5 (746.9–770.1) | 901.6 (887–916.1) | 1.19 | 889.4 (871.5–907.2) | 1.17 | 830 (811.9–848.1) | 1.09 | 829.1 (806.9–851.3) | 1.09 | 747.2 (722.8–771.6) | 0.99 | 589.7 (576.1–603.3) | 0.78 |
Sep-20 | 866.5 (853.4–879.6) | 1039.6 (1023.1–1056.2) | 1.20 | 1017.6 (997.7–1037.6) | 1.17 | 942.1 (922.1–962.1) | 1.09 | 917.7 (893.9–941.5) | 1.06 | 871.9 (844.3–899.4) | 1.01 | 668.6 (653.7–683.5) | 0.77 |
Oct-20 | 1051.2 (1035.3–1067.1) | 1228.4 (1208.9–1248) | 1.17 | 1227.7 (1203.4–1252) | 1.17 | 1148.7 (1124.2–1173.3) | 1.09 | 1146.7 (1116.5–1176.9) | 1.09 | 1022.7 (989.7–1055.7) | 0.97 | 788.1 (770.3–805.8) | 0.75 |
Nov-20 | 925.3 (911.2–939.5) | 1068.7 (1051.4–1086.1) | 1.15 | 1069.3 (1047.2–1091.3) | 1.16 | 1006.7 (984–1029.4) | 1.09 | 1010.4 (982.2–1038.7) | 1.09 | 885.1 (854.4–915.7) | 0.96 | 718.4 (701.3–735.5) | 0.78 |
Dec-20 | 796.1 (783.7–808.5) | 948.8 (933–964.6) | 1.19 | 928.4 (907.9–948.8) | 1.17 | 883.7 (862.3–905.2) | 1.11 | 877.6 (850.9–904.3) | 1.10 | 793.3 (762.9–823.6) | 1.00 | 641.1 (624.5–657.7) | 0.81 |
Jan-21 | 994.8 (979.1–1010.5) | 1208.4 (1187.8–1228.9) | 1.21 | 1161.6 (1134.2–1189) | 1.17 | 1109.3 (1079.9–1138.6) | 1.12 | 1135.4 (1097.1–1173.6) | 1.14 | 982.3 (940.2–1024.4) | 0.99 | 805.4 (782.6–828.2) | 0.81 |
Feb-21 | 893.4 (879–907.9) | 1091.5 (1072.2–1110.8) | 1.22 | 1050 (1023–1077) | 1.18 | 999.7 (970.7–1028.8) | 1.12 | 1006.8 (969–1044.6) | 1.13 | 923.4 (878.8–967.9) | 1.03 | 734.7 (711.6–757.8) | 0.82 |
Mar-21 | 1022.9 (1005.6–1040.1) | 1259 (1235.5–1282.5) | 1.23 | 1180.1 (1147–1213.2) | 1.15 | 1173.4 (1135.7–1211.1) | 1.15 | 1155.2 (1106.8–1203.6) | 1.13 | 1064 (1006.3–1121.6) | 1.04 | 853.4 (823.6–883.2) | 0.83 |
White—baseline | Black | Asian | Mixed | Other | Unknown | Missing | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Consultation rate | Relative ratea | Consultation rate | Relative ratea | Consultation rate | Relative ratea | Consultation rate | Relative ratea | Consultation rate | Relative ratea | Consultation rate | Relative ratea | ||
Face-to-face consultations | |||||||||||||
Feb-20 | 534.8 (525.7–543.9) | 656.7 (644.7–668.8) | 1.23 | 675.9 (659–692.8) | 1.26 | 555.7 (539.8–571.7) | 1.04 | 613.2 (591–635.4) | 1.15 | 490.1 (467.2–513.1) | 0.92 | 422 (408.9–435.2) | 0.79 |
Mar-20 | 357.9 (351.2–364.7) | 415.3 (406.5–424.1) | 1.16 | 417.9 (404.2–431.7) | 1.17 | 372.9 (358.5–387.3) | 1.04 | 391.3 (371.5–411.1) | 1.09 | 341.5 (318.7–364.3) | 0.95 | 270.3 (258.5–282.1) | 0.76 |
Apr-20 | 299.1 (293.6–304.5) | 354.7 (347.5–361.8) | 1.19 | 348.2 (337.8–358.7) | 1.16 | 313.6 (302.6–324.6) | 1.05 | 332.3 (317.2–347.5) | 1.11 | 282.6 (265.8–299.5) | 0.94 | 226.5 (217.5–235.4) | 0.76 |
May-20 | 305 (299.6–310.4) | 356.8 (350–363.7) | 1.17 | 349.4 (339.8–358.9) | 1.15 | 319.9 (309.7–330) | 1.05 | 330 (316.6–343.4) | 1.08 | 292.8 (277.3–308.3) | 0.96 | 232.6 (224.4–240.8) | 0.76 |
Jun-20 | 332.2 (326.5–337.9) | 390.2 (383–397.5) | 1.17 | 384.5 (374.8–394.2) | 1.16 | 352 (341.9–362.2) | 1.06 | 363.2 (350–376.5) | 1.09 | 314.2 (299.4–328.9) | 0.95 | 257.9 (249.7–266.1) | 0.78 |
Jul-20 | 386.3 (379.8–392.8) | 460.1 (451.8–468.3) | 1.19 | 459.4 (448.6–470.2) | 1.19 | 414.1 (403.1–425) | 1.07 | 431.3 (417.1–445.5) | 1.12 | 364.5 (349.2–379.8) | 0.94 | 301.7 (293–310.4) | 0.78 |
Aug-20 | 356 (350–362) | 426.9 (419.3–434.4) | 1.20 | 417 (407.6–426.4) | 1.17 | 381.1 (371.6–390.5) | 1.07 | 400.9 (388.7–413.2) | 1.13 | 332.9 (320.1–345.8) | 0.94 | 278.9 (271.4–286.3) | 0.78 |
Sep-20 | 429.3 (422.2–436.4) | 517 (508–526) | 1.20 | 503.2 (492.2–514.2) | 1.17 | 465.8 (454.6–476.9) | 1.09 | 472.4 (458.6–486.2) | 1.10 | 406.8 (391.8–421.8) | 0.95 | 342.5 (333.7–351.3) | 0.80 |
Oct-20 | 534.5 (525.7–543.3) | 625.3 (614.5–636.2) | 1.17 | 629.5 (615.7–643.3) | 1.18 | 573.5 (559.7–587.2) | 1.07 | 604.8 (586.9-622.6) | 1.13 | 491.7 (473.3–510) | 0.92 | 410.7 (400.2–421.3) | 0.77 |
Nov-20 | 463.4 (455.6–471.1) | 542.9 (533.3–552.6) | 1.17 | 543.4 (531–555.8) | 1.17 | 500.5 (487.9–513.1) | 1.08 | 529.3 (512.8–545.8) | 1.14 | 425.4 (408.4–442.4) | 0.92 | 367.7 (357.7–377.7) | 0.79 |
Dec-20 | 393.9 (387.1–400.6) | 471.9 (463.3–480.5) | 1.20 | 464.5 (453.2–475.9) | 1.18 | 434.6 (422.8–446.4) | 1.10 | 452.6 (437.2–468) | 1.15 | 367 (350.8–383.2) | 0.93 | 319.4 (310–328.8) | 0.81 |
Jan-21 | 477.2 (468.9–485.4) | 575.6 (564.9–586.4) | 1.21 | 558.7 (544.1–573.4) | 1.17 | 531.5 (515.8–547.3) | 1.11 | 558.5 (537.4–579.5) | 1.17 | 435.9 (414.3–457.5) | 0.91 | 387.4 (374.8–399.9) | 0.81 |
Feb-21 | 442.7 (434.8–450.6) | 537.2 (526.8–547.7) | 1.21 | 519.2 (504.4–534) | 1.17 | 487.7 (471.8–503.7) | 1.10 | 507.2 (485.8–528.5) | 1.15 | 434.3 (410–458.6) | 0.98 | 367.4 (354.1–380.6) | 0.83 |
Mar-21 | 528.1 (518.4–537.9) | 643.1 (629.9–656.3) | 1.22 | 616.2 (596.9–635.5) | 1.17 | 586.2 (564.9–607.4) | 1.11 | 608.1 (579.5–636.7) | 1.15 | 495.4 (464.2–526.5) | 0.94 | 433.8 (416.3–451.2) | 0.82 |
Telephone consultations | |||||||||||||
Feb-20 | 189 (184.7–193.3) | 187.1 (182.3–191.8) | 0.99 | 179.8 (173.2–186.4) | 0.95 | 207.6 (199.2–215.9) | 1.10 | 176.3 (166.6–186) | 0.93 | 195.8 (183–208.5) | 1.04 | 136.1 (129.8–142.5) | 0.72 |
Mar-20 | 410.9 (401.5–420.4) | 488.2 (475.7–500.7) | 1.19 | 498 (479.4–516.6) | 1.21 | 459.6 (440–479.1) | 1.12 | 419.9 (396.4–443.4) | 1.02 | 424.8 (395–454.7) | 1.03 | 287.8 (274.1–301.5) | 0.70 |
Apr-20 | 399.2 (390.1–408.3) | 458.5 (447.1–469.9) | 1.15 | 458.3 (442.4–474.2) | 1.15 | 437.5 (420.5–454.6) | 1.10 | 412.1 (391.3–432.9) | 1.03 | 414.3 (388.2–440.4) | 1.04 | 305.3 (292–318.5) | 0.76 |
May-20 | 405 (395.9–414.1) | 483.1 (471.4–494.8) | 1.19 | 464.9 (449.8–480) | 1.15 | 448.5 (432.4–464.5) | 1.11 | 422.8 (403.6–442.1) | 1.04 | 396.3 (374–418.6) | 0.98 | 291.8 (280.4–303.3) | 0.72 |
Jun-20 | 424.3 (414.9–433.7) | 494.4 (482.7–506.1) | 1.17 | 479.6 (465–494.1) | 1.13 | 461.5 (446.3–476.6) | 1.09 | 437.3 (419.2–455.4) | 1.03 | 454.4 (431.5–477.2) | 1.07 | 305.8 (294.8–316.7) | 0.72 |
Jul-20 | 465.6 (455.4–475.8) | 548.7 (535.9–561.4) | 1.18 | 555.4 (539.5–571.4) | 1.19 | 512.5 (496.8–528.2) | 1.10 | 483.8 (465.5–502.1) | 1.04 | 482.1 (460.1–504) | 1.04 | 340.3 (329–351.5) | 0.73 |
Aug-20 | 402.9 (394–411.7) | 468.5 (457.6–479.3) | 1.16 | 473.8 (460.6–487.1) | 1.18 | 446.9 (433.8–460.1) | 1.11 | 437.9 (422.2–453.6) | 1.09 | 427.3 (409.2–445.4) | 1.06 | 309.2 (299.5–318.9) | 0.77 |
Sep-20 | 427 (417.7–436.2) | 508 (496.4–519.6) | 1.19 | 504.5 (490.8–518.3) | 1.18 | 477.5 (463.8–491.2) | 1.12 | 449 (433.3–464.7) | 1.05 | 456.4 (437.7–475.2) | 1.07 | 324.3 (314.4–334.2) | 0.76 |
Oct-20 | 474.7 (464.4–485) | 549.3 (536.8–561.8) | 1.16 | 553.4 (538.1–568.8) | 1.17 | 539.8 (524.1–555.5) | 1.14 | 503.5 (485.7–521.3) | 1.06 | 500.6 (479.6–521.7) | 1.05 | 359 (347.9–370.1) | 0.76 |
Nov-20 | 455.2 (445.3–465.2) | 522.2 (510.1–534.3) | 1.15 | 524.8 (509.8–539.8) | 1.15 | 509.4 (494–524.9) | 1.12 | 478.4 (460.5–496.3) | 1.05 | 480 (458.4–501.6) | 1.05 | 341.8 (330.7–352.9) | 0.75 |
Dec-20 | 408.2 (399.1–417.3) | 474.1 (462.9–485.4) | 1.16 | 478.5 (464–493) | 1.17 | 464.9 (449.7–480.1) | 1.14 | 448.9 (430.6–467.1) | 1.10 | 438.4 (416.7–460.2) | 1.07 | 319 (307.8–330.3) | 0.78 |
Jan-21 | 495.4 (484.4–506.5) | 592.5 (578.3–606.8) | 1.20 | 580 (561.3–598.6) | 1.17 | 563.2 (543.4–583.1) | 1.14 | 540.2 (516.1–564.3) | 1.09 | 522.9 (494–551.9) | 1.06 | 399.3 (384–414.6) | 0.81 |
Feb-21 | 430.9 (421–440.8) | 509.1 (496.4–521.8) | 1.18 | 501.5 (484–518.9) | 1.16 | 489.7 (470.8–508.5) | 1.14 | 484.4 (460.4–508.4) | 1.12 | 485.2 (455.1–515.3) | 1.13 | 349.4 (334.6–364.1) | 0.81 |
Mar-21 | 468.4 (457.3–479.4) | 560 (545.4–574.5) | 1.20 | 555.4 (534.4–576.3) | 1.19 | 545.1 (522.1–568.2) | 1.16 | 520.6 (492–549.2) | 1.11 | 519.5 (483.3–555.6) | 1.11 | 376.7 (359.1–394.3) | 0.80 |