Perceived Access to Health Care Services and Relevance of Telemedicine during the COVID-19 Pandemic in Germany

Abstract

During the COVID-19 pandemic in Germany, non-pharmaceutical interventions were imposed to contain the spread of the virus. Based on cross-sectional waves in March, July and December 2020 of the COVID-19 Snapshot Monitoring (COSMO), the present study investigated the impact of the introduced measures on the perceived access to health care. Additionally, for the wave in December, treatment occasion as well as utilization and satisfaction regarding telemedicine were analysed. For 18–74-year-old participants requiring medical care, descriptive and logistic regression analyses were performed. During the less strict second lockdown in December, participants reported more frequently ensured access to health care (91.2%) compared to the first lockdown in March (86.8%), but less frequently compared to July (94.2%) during a period with only mild restrictions. In December, main treatment occasions of required medical appointments were check-up visits at the general practitioner (55.2%) and dentist (36.2%), followed by acute treatments at the general practitioner (25.6%) and dentist (19.0%), treatments at the physio-, ergo- or speech therapist (13.1%), psychotherapist (11.9%), and scheduled hospital admissions or surgeries (10.0%). Of the participants, 20.0% indicated utilization of telemedical (15.4% telephone, 7.6% video) consultations. Of them, 43.7% were satisfied with the service. In conclusion, for the majority of participants, access to medical care was ensured during the COVID-19 pandemic; however, access slightly decreased during phases of lockdown. Telemedicine complemented the access to medical appointments.

Use of and Satisfaction with Telemedicine Services during the Pandemic: Findings from the COVID-19 Snapshot Monitoring in Germany (COSMO)

“…On the other side, individuals may truly appreciate the fact that they can at least supplement some physician visits via telemedicine services during times of the pandemic. In sum, our findings are also in line with the previously mentioned study in Germany (and international research, e.g., [ 17 ]) conducted during the pandemic [ 7 ].…”

“…The proportion of individuals replacing physician visits by telemedicine services in Germany during the pandemic mainly confirms previous findings made by Reitzle et al (also conducted in Germany, but in December 2020) [ 7 ]. Additionally, they demonstrated that appointments were more frequently performed via telephone compared to video calls [ 7 ].…”

“…The association between lower education and a higher likelihood of using telemedicine services (as replacement of physician visits) appears surprising and counterintuitive. Reitzle et al also showed that video consultations were more often used by participants with a higher educational level [ 7 ]. A possible explanation may be that individuals with a lower education had worse possibilities for individual transport in pandemic (e.g., no own car and cannot affording a cab) compared to higher educated individuals.…”

“…Moreover, about 20% of adults stated that they used telemedicine services (telephone, video or both) instead of physician visits in Germany in December 2020. It should be noted that the study by Reitzle et al [ 7 ] solely focused on the replacement of physician visits by telemedicine services in Germany in December 2020 (i.e., a snapshot from the situation—including satisfaction with such services—in December 2020), whereas our current study focused on replacement of physician visits by telemedicine services in Germany over the whole course of the pandemic (from March 2020 to August 2021). Another similar study only focused on patient satisfaction with telemedicine in a single-institution, urban, quaternary academic medical center in New York City until the end of May 2020, whereas we used data from the general adult population (and included later stages of the pandemic).…”

The impact of the COVID-19 pandemic on perceived access to health care and preferences for health care provision in individuals (being) treated for breast cancer

“…A study from Germany, where comparable government measures were implemented during the pandemic, observed that 13.2% ( n = 102) of the individuals requiring access to medical appointments experienced limited access to a general practitioner during the first wave in April 2020. This proportion decreased to 8.8% ( n = 76) during the second wave in December 2020 [ 17 ]. In the present study, the proportion of patients who felt higher barriers to contact their general practitioner due to COVID-19 decreased with 9.1% during the pandemic, despite persisting higher barriers to contact a general practitioner among 20.8% of the patients during the second wave.…”