Publication date: Jul 07, 2023

Data on population healthcare utilisation (HCU) across both primary and secondary care during the COVID-19 pandemic are lacking. We describe primary and secondary HCU stratified by long-term conditions (LTCs) and deprivation, during the first 19 months of COVID-19 pandemic across a large urban area in the UK. A retrospective, observational study. All primary and secondary care organisations that contributed to the Greater Manchester Care Record throughout 30 December 2019 to 1 August 2021. 3 225 169 patients who were registered with or attended a National Health Service primary or secondary care service during the study period. Primary care HCU (incident prescribing and recording of healthcare information) and secondary care HCU (planned and unplanned admissions) were assessed. The first national lockdown was associated with reductions in all primary HCU measures, ranging from 24. 7% (24. 0% to 25. 5%) for incident prescribing to 84. 9% (84. 2% to 85. 5%) for cholesterol monitoring. Secondary HCU also dropped significantly for planned (47. 4% (42. 9% to 51. 5%)) and unplanned admissions (35. 3% (28. 3% to 41. 6%)). Only secondary care had significant reductions in HCU during the second national lockdown. Primary HCU measures had not recovered to prepandemic levels by the end of the study. The secondary admission rate ratio between multi-morbid patients and those without LTCs increased during the first lockdown by a factor of 2. 40 (2. 05 to 2. 82; p

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