From disruption to recovery: Trends in acute condition attendances at Western Singapore polyclinics during and after the COVID-19 pandemic.

Abstract

The COVID-19 pandemic (2020-2022) significantly disrupted healthcare delivery, with primary care utilization patterns shifting in response to public health interventions and system adaptations. Understanding these changes is essential to inform future preparedness and service planning. We conducted a retrospective descriptive study of weekly attendances at five public polyclinics in western Singapore from January 2019 to June 2022. Attendances were categorized using ICD-10-CM codes into three groups: acute respiratory infections (ARI), acute non-respiratory infections (ANRI), and acute non-infective conditions (ANI). Trends were examined across three phases: pre-pandemic, pandemic, and transition to post-pandemic. A marked decline in attendances was observed across all three condition categories during the pandemic, with the most pronounced and sustained reductions seen in ANRI and ANI visits. ARI attendances also declined initially, but later rebounded and constituted an increasing proportion of acute presentations over time. Shifts were temporally aligned with key national policy changes, including movement restrictions and changes in healthcare access points. Pandemic-related interventions and behavioral adaptations led to substantial and lasting shifts in primary care acute illness attendances. Reduced medical certification requirements, telehealth uptake, and diversion to Public Health Preparedness Clinics likely contributed to these patterns. The findings underscore the importance of adaptive service models, and integrated data monitoring to strengthen health system resilience in future public health emergencies.