Provision of scheduled outpatient consultations for patients with non-communicable diseases during the COVID-19 emergency in spring 2020 in Latvia

The study aimed to assess the changes in provision of the total and remote consultations by family physicians and specialists during scheduled on-site outpatient consulting suspension (except for oncological patients) due to the COVID-19 emergency in Spring 2020. The study was carried out in the frame of the National research programme project VPP-COVID-2020/1-0011. Data from the National Health Service for selected non-communicable diseases were analyzed, including diseases with suspended on-site consultations for diabetes (E10; E11), cardiovascular diseases (CVD) (I10; I20-I25; I50), asthma (J44; J45), and oncological diseases with ongoing on-site consultations (breast (C50) and prostate cancer (C61)). Proportionate 2020 weekly consultation volume against 2019 was assessed, and its average for 13th-16th week was calculated, as well as remote consultation proportion out of total. On average, during 13th-16th week the largest decrease of consultation volume was seen for both family physicians and specialists, respectively: 63.1% and 76.6% for diabetes, 74.8% and 29.7% for CVD, 85.3% and 35.1% for asthma, 80.2% and 110.0% for breast cancer, 71.6% and 68.8% for prostate cancer. During 13th-16th week a gradual increase of remote consultation proportion was seen in all groups of diagnosis both for family physicians and specialists, respectively: 47.1% and 85.2% for diabetes, 53.4% and 63.3% for CVD, 44.9% and 67.4% for asthma, 40.5% and 38.9% for breast cancer, 36.4% and 23.9% for prostate cancer at the highest point during the period. A reduction of total consultation volume in 2020 compared with 2019 was observed for all groups of diagnosis and for both family physicians and specialists, including oncological diseases, with one exception – specialists’ consultations for breast cancer patients. On-site consultations partly were replaced with remote consultations, but without the capacity to compensate for the total decrease. Further research is needed on remote consultation implementation as a valuable tool and their sustainable provision.