Changes in Reasons for Visits to Primary Care as a Result of the COVID-19 Pandemic: by INTRePID
Why this work is in the frame
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Bibliographic record
Abstract
<h3>Context:</h3> The COVID-19 pandemic has resulted in changes in healthcare delivery in many countries around the world. <h3>Objective:</h3> To examine the impact of the pandemic on reasons for visits to primary care through the International Consortium of Primary Care Big Data Researchers (INTRePID). <h3>Study Design and Analysis:</h3> Cross-sectional retrospective analysis of visit volume, modality and reason for visit from 2018-2021. <h3>Setting:</h3> Patients seen in primary care settings in Argentina, Australia, Canada, China, Peru, Norway, Singapore, Sweden and USA. <h3>Outcome Measures:</h3> Monthly visit volume, rates of virtual vs in-person visits for the top 10 reasons for visits to primary care and for common conditions. <h3>Results:</h3> There were over 215 million visits to primary care in INTRePID countries during the study period. The average monthly visit volume decreased in the first year of the pandemic for INTRePID countries (-20.4% to -43.5%, p=.03 to <.001) except for in Norway, Canada and Sweden (.3%, -.8% and - 9.7%, p=.68, .84, .11 respectively) and increased in Australia (+19%, p=0.013). While Argentina, China and Singapore had little to no virtual care, in the other INTRePID countries the average monthly virtual visit rate ranged from a low in Peru (7.3% first year, 5.2 % second year of the pandemic) to a high in Canada (75.8% first year, 62.5% second year of the pandemic). For anxiety/depression the average monthly visit volume in the first year of the pandemic was higher than pre-pandemic in Australia, Canada, Peru and Singapore (18.9% to 42.2%, p=.004 to <.001). Average monthly visit volume for coughs and colds dropped for all countries in the first year of the pandemic (-47.0% to -86.5%, p=.92 to <.001). <h3>Conclusions:</h3> While visits to primary care generally declined, the rapid introduction of virtual visits mitigated much of the visit volume disruption in many countries. The pandemic resulted in changes in how primary care is delivered and some changes in what is seen in primary care. It appears that virtual care is likely to be part of a new normal in primary care delivery in many countries.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it