{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:33:07Z","timestamp":1777595587194,"version":"3.51.4"},"reference-count":42,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2022,7,6]],"date-time":"2022-07-06T00:00:00Z","timestamp":1657065600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004040","name":"KU Leuven","doi-asserted-by":"publisher","award":["3M190682"],"award-info":[{"award-number":["3M190682"]}],"id":[{"id":"10.13039\/501100004040","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>The Covid-19 pandemic had a tremendous impact on healthcare but uncertainty remains about the extent to which primary care provision was affected. Therefore, this paper aims to assess the impact on primary care provision and the evolution of the incidence of disease during the first year of the Covid-19 pandemic in Flanders (Belgium).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Care provision was defined as the number of new entries added to a patient\u2019s medical history. Pre-pandemic care provision (February 1, 2018\u2013January 31, 2020) was compared with care provision during the pandemic (February 1, 2020-January 31, 2021). A large morbidity registry (Intego) was used. Regression models compared the effect of demographic characteristics on care provision and on acute and chronic diagnoses incidence both prior and during the pandemic.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>During the first year of the Covid-19 pandemic, overall care provision increased with 9.1% (95%CI 8.5%;9.6%). There was an increase in acute diagnoses of 5.1% (95%CI 4.2%;6.0%) and a decrease in the selected chronic diagnoses of 12.8% (95% CI 7.0%;18.4%). Obesity was an exception with an overall incidence increase. The pandemic led to strong fluctuations in care provision that were not the same for all types of care and all demographic groups in Flanders. Relative to other groups in the population, the pandemic caused a reduction in care provision for children aged 0\u201317 year and patients from a lower socio-economic situation.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>This paper strengthened the claim that Covid-19 should be considered as a syndemic instead of a pandemic. During the first Covid-19 year, overall care provision and the incidence of acute diagnoses increased, whereas chronic diseases\u2019 incidence decreased, except for obesity diagnoses which increased. More granular, care provision and chronic diseases\u2019 incidence decreased during the lockdowns, especially for people with a lower socio-economic status. After the lockdowns they both returned to baseline.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0271049","type":"journal-article","created":{"date-parts":[[2022,7,6]],"date-time":"2022-07-06T17:35:23Z","timestamp":1657128923000},"page":"e0271049","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":28,"title":["The impact of the Covid-19 pandemic on the incidence of diseases and the provision of primary care: A registry-based study"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0744-3923","authenticated-orcid":true,"given":"Steve","family":"Van den Bulck","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonas","family":"Cr\u00e8vecoeur","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bert","family":"Aertgeerts","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Delvaux","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Neyens","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gijs","family":"Van Pottelbergh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Coursier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5244-1930","authenticated-orcid":true,"given":"Bert","family":"Vaes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,7,6]]},"reference":[{"issue":"15","key":"pone.0271049.ref001","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.1056\/NEJMsb2021088","article-title":"Covid-19\u2014Implications for the Health Care System","volume":"383","author":"D Blumenthal","year":"2020","journal-title":"New England Journal of Medicine"},{"issue":"1","key":"pone.0271049.ref002","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1186\/s12875-020-01278-8","article-title":"Primary care in the time of COVID-19: monitoring the effect of the pandemic and the lockdown measures on 34 quality of care indicators calculated for 288 primary care practices covering about 6 million people in Catalonia","volume":"21","author":"E Coma","year":"2020","journal-title":"BMC family practice"},{"key":"pone.0271049.ref003","article-title":"Economic impact of COVID-19 pandemic on healthcare facilities and systems: International perspectives","author":"AD Kaye","year":"2020","journal-title":"Best Pract Res Clin Anaesthesiol"},{"key":"pone.0271049.ref004","doi-asserted-by":"crossref","first-page":"100882","DOI":"10.1016\/j.cegh.2021.100882","article-title":"Review of COVID-19 epidemiology and public health response in Europe in 2020","volume":"12","author":"M Nanda","year":"2021","journal-title":"Clinical epidemiology and global health"},{"issue":"1","key":"pone.0271049.ref005","doi-asserted-by":"crossref","first-page":"2023","DOI":"10.1016\/j.sapharm.2020.04.007","article-title":"Medication management and adherence during the COVID-19 pandemic: Perspectives and experiences from low-and middle-income countries","volume":"17","author":"IA Kretchy","year":"2021","journal-title":"Research in Social and Administrative Pharmacy"},{"issue":"1","key":"pone.0271049.ref006","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1186\/s12875-020-01326-3","article-title":"The impact of COVID-19 on chronic care according to providers: a qualitative study among primary care practices in Belgium","volume":"21","author":"K Danhieux","year":"2020","journal-title":"BMC family practice"},{"issue":"5","key":"pone.0271049.ref007","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1016\/j.dsx.2020.06.042","article-title":"Impact of COVID-19 on routine care for chronic diseases: A global survey of views from healthcare professionals","volume":"14","author":"YV Chudasama","year":"2020","journal-title":"Diabetes & Metabolic Syndrome: Clinical Research & Reviews"},{"issue":"22","key":"pone.0271049.ref008","doi-asserted-by":"crossref","first-page":"2237","DOI":"10.1001\/jama.2020.7308","article-title":"How Will COVID-19 Affect the Health Care Economy?","volume":"323","author":"D. 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