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Original article Influence of practice location on prescribing, diabetes care, and colorectal cancer screening among Czech general practitioners during the COVID-19 pandemic
Jan Bělobrádek1orcid , Luděk Šídlo2orcid , Tom Philipp4,3orcid
Epidemiol Health 2024;e2024033
DOI: https://doi.org/10.4178/epih.e2024033 [Accepted]
Published online: February 23, 2024
1Charles University, Faculty of Medicine in Hradec Králové , Hradec Králové, Czech Republic
2Charles University, Faculty of Science, Department of Demography and Geodemography, Praha, Czech Republic
3General Health Insurance Company (GHIC), Board of Trustees, Praha, Czech Republic
4Charles University, Third Faculty of Medicine, Rheumatology and Rehabilitation Clinic, Praha, Czech Republic
Corresponding author:  Jan Bělobrádek,
Email: mudrjanbelobradek@gmail.com
Received: 17 August 2023   • Revised: 9 January 2024   • Accepted: 10 January 2024
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OBJECTIVES
The provision of primary health care was not interrupted during the coronavirus disease 2019 (COVID-19) pandemic in Czechia, although the capacity and resources of providers changed. We examined how the pandemic affected individual general practices throughout 2017‒2021, focusing on differences between urban and rural practices.
METHODS
We analysed data from the largest health insurance company in Czechia, which provides care to 4.5 million people (60% of the population). We evaluated the prescription volume, diabetes care procedures, and faecal immunochemical test (FIT) in preventive care and new pandemic-related procedures (remote consultations, testing, and vaccinations). For the spatial distribution of practices, we adapted the Organisation for Economic Co-operation and Development typology.
RESULTS
We observed minimal declines in 2020 in the rate of prescribing (-1%) and diabetes care (-5.1%), with a rapid resumption in 2021, but a substantial decline in FIT (-17.8% in 2020) with slow resumption. Remote consultations were used by 94% of all practices regardless of location, with testing and vaccinations more commonly performed by rural general practitioners.
CONCLUSIONS
Primary care in Czechia rose to the challenge of the COVID-19 pandemic, as shown by the finding that the volume of healthcare services provided through primary care did not decrease across most of the monitored parameters. This study also confirmed that rural GPs provide more care in-house, both in terms of prescribing and procedures performed in their practices. Future studies will need to focus on preventive care, which the pandemic has dampened in GP practices in Czechia.


Epidemiol Health : Epidemiology and Health