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@ARTICLE{Michalowsky:156006,
      author       = {Michalowsky, Bernhard and Hoffmann, Wolfgang and Bohlken,
                      Jens and Kostev, Karel},
      title        = {{E}ffect of the {COVID}-19 lockdown on disease recognition
                      and utilisation of healthcare services in the older
                      population in {G}ermany: a cross-sectional study.},
      journal      = {Age $\&$ ageing},
      volume       = {50},
      number       = {2},
      issn         = {1468-2834},
      address      = {Oxford},
      publisher    = {Oxford Univ. Press},
      reportid     = {DZNE-2021-01138},
      pages        = {317 - 325},
      year         = {2021},
      abstract     = {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.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.Cross-sectional observational study.1,095 general
                      practitioners (GPs) and 960 specialist practices in
                      Germany.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.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.The data suggest that
                      organisational changes were adopted quickly by practice
                      management but also raise concerns about the maintenance of
                      routine care. Prospective studies should evaluate the
                      long-term effects of lockdowns on patient-related outcomes.},
      keywords     = {Aged / COVID-19: diagnosis / COVID-19: epidemiology /
                      COVID-19: prevention $\&$ control / COVID-19: therapy /
                      Communicable Disease Control: organization $\&$
                      administration / Cross-Sectional Studies / Delayed
                      Diagnosis: adverse effects / Delayed Diagnosis: statistics
                      $\&$ numerical data / Delivery of Health Care: methods /
                      Delivery of Health Care: organization $\&$ administration /
                      Female / Germany: epidemiology / Humans / Male /
                      Noncommunicable Diseases: epidemiology / Noncommunicable
                      Diseases: therapy / Organizational Innovation / Patient
                      Acceptance of Health Care: statistics $\&$ numerical data /
                      Quarantine: methods / SARS-CoV-2 / COVID-19 (Other) /
                      healthcare utilisation (Other) / lockdown (Other) / older
                      people (Other) / recognition (Other)},
      cin          = {AG Hoffmann},
      ddc          = {610},
      cid          = {I:(DE-2719)1510600},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:33205150},
      pmc          = {pmc:PMC7717143},
      doi          = {10.1093/ageing/afaa260},
      url          = {https://pub.dzne.de/record/156006},
}