The evolution of consultation practices with general practitioners and nephrologists for patients with chronic kidney disease before and after the COVID-19 pandemic in France.
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| Titel: | The evolution of consultation practices with general practitioners and nephrologists for patients with chronic kidney disease before and after the COVID-19 pandemic in France. |
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| Autoren: | Piveteau J; EHESP, CNRS, Inserm, Arènes-UMR 6051, RSMS, U1309, Univ Rennes, Rennes, France., Bayat S; EHESP, CNRS, Inserm, Arènes-UMR 6051, RSMS, U1309, Univ Rennes, Rennes, France., Vigneau C; Univ Rennes, CHU Rennes, INSERM, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail)-UMR S 1085, Rennes, France., Couchoud C; Renal Epidemiology and Information Network (REIN) Registry, Biomedicine Agency, Saint-Denis-La-Plaine, France., Raffray M; Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Solna, Sweden. maxime.raffray@ki.se. |
| Quelle: | Journal of nephrology [J Nephrol] 2025 Nov; Vol. 38 (8), pp. 2407-2416. Date of Electronic Publication: 2025 Jul 27. |
| Publikationsart: | Journal Article |
| Sprache: | English |
| Info zur Zeitschrift: | Publisher: Springer Country of Publication: Italy NLM ID: 9012268 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1724-6059 (Electronic) Linking ISSN: 11218428 NLM ISO Abbreviation: J Nephrol Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2014- : Heidelberg : Springer Original Publication: Rome : Acta Medica, |
| MeSH-Schlagworte: | COVID-19*/epidemiology , Renal Insufficiency, Chronic*/therapy , Renal Insufficiency, Chronic*/epidemiology , Renal Insufficiency, Chronic*/diagnosis , General Practitioners*/trends , Nephrologists*/trends , Nephrologists*/statistics & numerical data , Referral and Consultation*/trends , Referral and Consultation*/statistics & numerical data, Humans ; France/epidemiology ; Male ; Female ; Middle Aged ; Aged ; Adult ; Hospitalization/statistics & numerical data ; SARS-CoV-2 ; Telemedicine ; Remote Consultation/trends ; Pandemics ; Practice Patterns, Physicians'/trends ; Aged, 80 and over ; Young Adult |
| Abstract: | Competing Interests: Declarations. Conflict of interest: On behalf of all the authors, the corresponding author states that there is no conflict of interest. The results presented in this paper have not been published previously in whole or part, except in abstract form. Ethical approval: This retrospective study was performed in accordance with the ethical standards of the institutional and national research committee. Informed consent to participate: SNDS is a pseudonymized database and no individual patient consent was required. Background: The COVID-19 pandemic led to concerns about disruptions in the follow-up of chronic diseases, including chronic kidney disease (CKD). Here, we assessed the COVID-19 pandemic impact on healthcare use by patients with CKD in France. Methods: We used the French National Health Data System (SDNS) that contains data on outpatient and inpatient healthcare of the whole French population. Using a validated algorithm, we identified two CKD cohorts based on their healthcare utilization: (i) the 2019 cohort (pandemic-exposed) and (ii) the 2017 cohort (comparator). We followed these cohorts for 2 years and compared consultations (in-person and teleconsultation) with a general practitioner (GP) and a nephrologist and all-cause hospitalizations (excluding COVID-19 as primary diagnosis). We stratified comparisons by age group and sex. Results: We identified 4,866,096 individuals with CKD in 2017 and 5,089,706 in 2019. During the first year of follow-up, 95.2% and 6.4% of patients in the 2017 cohort had at least one consultation with a GP and with a nephrologist, respectively, versus 94% and 6.3% in the 2019 cohort. Teleconsultations compensated for the reduction of in-person GP and nephrologist consultations throughout the lockdown periods in 2020 and 2021 (40.5% of patients in the 2019 cohort had at least one in-person consultation and 52.5% an in-person or tele-consultation with a GP). Hospitalizations ≥ 24 h decreased in 2020 and 2021 (-10%). Conclusions: In France, outpatient care for CKD was maintained during the 2 years following the COVID-19 pandemic, thanks to teleconsultations. The persistently lower inpatient care utilization warrants further investigation. (© 2025. The Author(s).) |
| References: | BMC Prim Care. 2022 Aug 9;23(1):200. (PMID: 35945511) Health Aff (Millwood). 2023 Dec;42(12):1667-1674. (PMID: 38048493) Mayo Clin Proc Digit Health. 2024 Nov 16;3(1):100181. (PMID: 40207003) Kidney Int. 2022 Sep;102(3):652-660. (PMID: 35724769) BMC Public Health. 2009 Jan 22;9:33. (PMID: 19161613) Kidney Int Rep. 2023 Feb 03;8(4):785-795. (PMID: 37069994) Clin Kidney J. 2024 Nov 22;17(Suppl 2):1-8. (PMID: 39583140) J Am Soc Nephrol. 2021 Nov;32(11):2948-2957. (PMID: 34535558) Fam Pract. 2022 Jan 19;39(1):168-182. (PMID: 34278421) Health Aff (Millwood). 2024 Jan;43(1):125-130. (PMID: 38190599) J Gen Intern Med. 2022 Dec;37(16):4241-4247. (PMID: 36163529) Clin Kidney J. 2022 Jul 26;15(11):2124-2134. (PMID: 36325010) Health Policy. 2022 May;126(5):427-437. (PMID: 34497031) Nat Rev Nephrol. 2020 Dec;16(12):705-706. (PMID: 32848205) Rev Epidemiol Sante Publique. 2017 Oct;65 Suppl 4:S149-S167. (PMID: 28756037) Lancet Reg Health Eur. 2022 Jun 30;20:100438. (PMID: 36090671) J Nephrol. 2025 Sep;38(7):1877-1887. (PMID: 40261602) Kidney Med. 2022 Nov;4(11):100537. (PMID: 36035616) Eur Heart J. 2022 Sep 1;43(33):3164-3178. (PMID: 36044988) Eur J Neurol. 2020 Sep;27(9):1783-1787. (PMID: 32399995) BMJ. 2023 Jul 19;382:e075133. (PMID: 37468148) Nephrol Dial Transplant. 2006 Feb;21(2):411-8. (PMID: 16234286) Nature. 2020 Aug;584(7821):430-436. (PMID: 32640463) Nephrol Dial Transplant. 2020 Nov 1;35(11):1973-1983. (PMID: 33151337) Clin Kidney J. 2024 Apr 23;17(5):sfae117. (PMID: 38774439) Can J Kidney Health Dis. 2022 Jan 05;9:20543581211066720. (PMID: 35024152) J Gen Intern Med. 2023 Apr;38(5):1232-1238. (PMID: 36650332) Lancet Public Health. 2020 Oct;5(10):e536-e542. (PMID: 32950075) Kidney Int. 2024 Apr;105(4S):S117-S314. (PMID: 38490803) |
| Contributed Indexing: | Keywords: COVID-19; Chronic kidney disease; Healthcare utilization; Teleconsultation |
| Entry Date(s): | Date Created: 20250727 Date Completed: 20251119 Latest Revision: 20251122 |
| Update Code: | 20251122 |
| PubMed Central ID: | PMC12630256 |
| DOI: | 10.1007/s40620-025-02376-5 |
| PMID: | 40717177 |
| Datenbank: | MEDLINE |
Nájsť tento článok vo Web of Science | Abstract: | Competing Interests: Declarations. Conflict of interest: On behalf of all the authors, the corresponding author states that there is no conflict of interest. The results presented in this paper have not been published previously in whole or part, except in abstract form. Ethical approval: This retrospective study was performed in accordance with the ethical standards of the institutional and national research committee. Informed consent to participate: SNDS is a pseudonymized database and no individual patient consent was required.<br />Background: The COVID-19 pandemic led to concerns about disruptions in the follow-up of chronic diseases, including chronic kidney disease (CKD). Here, we assessed the COVID-19 pandemic impact on healthcare use by patients with CKD in France.<br />Methods: We used the French National Health Data System (SDNS) that contains data on outpatient and inpatient healthcare of the whole French population. Using a validated algorithm, we identified two CKD cohorts based on their healthcare utilization: (i) the 2019 cohort (pandemic-exposed) and (ii) the 2017 cohort (comparator). We followed these cohorts for 2 years and compared consultations (in-person and teleconsultation) with a general practitioner (GP) and a nephrologist and all-cause hospitalizations (excluding COVID-19 as primary diagnosis). We stratified comparisons by age group and sex.<br />Results: We identified 4,866,096 individuals with CKD in 2017 and 5,089,706 in 2019. During the first year of follow-up, 95.2% and 6.4% of patients in the 2017 cohort had at least one consultation with a GP and with a nephrologist, respectively, versus 94% and 6.3% in the 2019 cohort. Teleconsultations compensated for the reduction of in-person GP and nephrologist consultations throughout the lockdown periods in 2020 and 2021 (40.5% of patients in the 2019 cohort had at least one in-person consultation and 52.5% an in-person or tele-consultation with a GP). Hospitalizations ≥ 24 h decreased in 2020 and 2021 (-10%).<br />Conclusions: In France, outpatient care for CKD was maintained during the 2 years following the COVID-19 pandemic, thanks to teleconsultations. The persistently lower inpatient care utilization warrants further investigation.<br /> (© 2025. The Author(s).) |
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| ISSN: | 1724-6059 |
| DOI: | 10.1007/s40620-025-02376-5 |