gms | German Medical Science

20. Deutscher Kongress für Versorgungsforschung

Deutsches Netzwerk Versorgungsforschung e. V.

06. - 08.10.2021, digital

Effect of the COVID-19 lockdown on disease recognition and utilisation of healthcare services in the older population in Germany: a cross-sectional study

Meeting Abstract

  • Bernhard Michalowsky - Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Greifswald, Deutschland
  • Karel Kostev - IQVIA, Frankfurt am Main, Deutschland
  • Jens Bohlken - Berufsverband Deutscher Nervenärzte, Berlin, Deutschland
  • Wolfgang Hoffmann - Institut für Community Medicine, Universitätsmedizin Greifswald, Greifswald, Deutschland

20. Deutscher Kongress für Versorgungsforschung (DKVF). sine loco [digital], 06.-08.10.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. Doc21dkvf383

doi: 10.3205/21dkvf383, urn:nbn:de:0183-21dkvf3838

Published: September 27, 2021

© 2021 Michalowsky et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



Background: There is little evidence about the utilisation of healthcare services and disease recognition in the older population, which was urged to self-isolate during the COVID-19 lockdown.

Objectives: We aimed to describe the utilisation of physician consultations, specialist referrals, hospital admissions and the recognition of incident diseases in Germany for this age group during the COVID-19 lockdown.

Methods: Cross-sectional study that based on data of 1,095 general practitioners (GPs) and 960 specialist practices in Germany and 2.45 million older patients aged 65 or older. The number of documented physician consultations, specialist referrals, hospital admissions and incident diagnoses during the imposed lockdown in 2020 was descriptively analysed and compared to 2019.

Results: Physician consultations decrease slightly in February (-2%), increase before the imposed lockdown in March (+9%) and decline in April (-18%) and May (-14%) 2020 compared to the same periods in 2019. Volumes of hospital admissions decrease earlier and more intensely than physician consultations (-39 versus -6%, respectively). Overall, 15, 16 and 18% fewer incident diagnoses were documented by GPs, neurologists and diabetologists, respectively, in 2020. Diabetes, dementia, depression, cancer and stroke were diagnosed less frequently during the lockdown (-17 to -26%), meaning that the decrease in the recognition of diseases was greater than the decrease in physician consultations.

Discussion: The data suggest that organisational changes were adopted quickly by practice management but also raise concerns about the maintenance of routine care.

Implication: Introduced measured to prevent the spread of the COVID-19 diseases were associated with a decreased utilisation of healthcare services but also caused a poor recognition of incident diseases, which could, in turn, cause adverse health-related outcomes.

Plea to the practice: Prospective studies should evaluate the long-term effects of lockdowns on patient-related outcomes.