Use of teleconsultations
Consultations with doctors are the most frequent contact most people have with health services and provide an entry point for subsequent medical treatment. Consultations can take place in different settings and are increasingly online. COVID-19 has had a substantial impact on how people consult doctors. Stay-at-home orders and the suspension of non-urgent care contributed to fewer in-person doctor consultations, which was partly offset by increased teleconsultations.
Governments acted rapidly at the beginning of the pandemic to promote the use of teleconsultations by introducing enabling legislation and revising laws (OECD, forthcoming[1]). After the pandemic started, at least four EU countries that allowed only in-person consultations dropped this restriction (Estonia, Hungary, Ireland and Luxembourg). Three additional EU countries relaxed a prerequisite that patients were allowed to have teleconsultations with physicians that they had already consulted in-person (France, Germany and Lithuania). Governments also promoted the use of telemedicine through changes in providers’ payment systems. Six EU countries began covering teleconsultations through government/compulsory schemes (Belgium, Czech Republic, Estonia, Hungary, Latvia and Luxembourg).
Between 2019 and 2020, in-person consultations fell by almost 20% on average across EU countries. In-person consultations fell by more than one-third in Lithuania and Spain, and by less than 10% in the Czech Republic and Finland. However, the declines in in-person consultations were completely offset by increasing numbers of teleconsultations in Poland, Denmark and Spain, and partly offset in many other countries (Figure 8.3). The share of teleconsultations doubled between 2019 and 2020 (from 11% to 22% [12 countries]). Before the pandemic, consultations via phone or video accounted for fewer than 10% in all but two EU countries. Denmark had the highest share of teleconsultations pre-pandemic, at 45%. Teleconsultations in Denmark were possible through different solutions, for example the national “My Doctor” mobile application that was set-up as part of its Digital Health Strategy 2018-22 (OECD/European Observatory on Health Systems and Policies, 2021[2]).
The Eurofound e-survey data highlight that the proportion of adults who reported having a medical consultation online or by phone increased dramatically during the pandemic: by mid-2020, almost one in three adults had used a teleconsultation, a proportion that went up to 40% by early 2021 (Figure 8.4). Countries where the use of teleconsultations was highest in mid-2020 also had higher growth rates between mid-2020 and early 2021, suggesting an increasing divergence. The proportion of adults who reported having a teleconsultation in February/March of 2021 ranged from less than 25% in France and Germany to more than 65% in Spain and Slovenia. The adaptation of health services to increased teleconsultations helped absorb the shock of the pandemic and prevented further infections.
Data on doctor consultations in person and through teleconsultations are based mainly on administrative data and were collected through an OECD/Eurostat/WHO-Europe Joint Questionnaire. The share of adults reporting medical consultations online or by phone during the pandemic was sourced from Eurofound’s Living, working and COVID-19 e-survey. The survey was undertaken in July 2020 and March 2021, with the relevant question (“Since the pandemic began, have you received any of the following services from a doctor – medical consultation online or by telephone?”). Caution is required when comparing between countries because of the open-ended nature of the question.
References
[1] OECD (forthcoming), The COVID-19 Pandemic and the Future of Telemedicine, OECD Health Policy Studies, OECD Publishing, Paris.
[2] OECD/European Observatory on Health Systems and Policies (2021), State of Health in the EU, Country Health Profiles, OECD Publishing, Paris, https://doi.org/10.1787/25227041.
Note: The EU average is unweighted. 1. Data for Spain are underestimated as they only include consultations in primary health care centres of the National Health System.
Source: OECD Health Statistics 2022 (for in-person consultations) and national sources (for teleconsultations); Eurostat Database.
