OBJECTIVES: Japan does not have a general practitioner (GP) system. During the COVID-19 pandemic, an unfair situation seemed to occur where many suspected COVID-19 patients were not accepted by healthcare facilities, while only those who had visited frequently were accepted, raising expectations for the GP system. However, the discussion about this system has focused on its definition, not on whether it would be useful for the future pandemic. We investigated the possibility of unfair situation during the COVID-19 pandemic.

METHODS: A claims database provided by DeSC Healthcare, Inc. (April 2014–January 2023) was used. Among patients with a first COVID-19 diagnosis and 1 year of observation period before the diagnosis (defined as baseline period), those with ≥1 hospital visit(s) and no inpatient during the baseline period were identified. The association between the first COVID-19 diagnosis facility and previous outpatient visits was analyzed in these patients.

RESULTS: Of 422,992 patients with the first COVID-19 diagnosis, 300,194 patients were analyzed. Patients who visited healthcare facilities more often during the baseline period more often received the first COVID-19 diagnosis in the facilities; however, 30%–40% of patients with ≥24 visits months (total number of months to all facilities) during the baseline period received their first COVID-19 diagnosis in facilities other than those previously visited. The percentage of patients who received their first COVID-19 diagnosis at a previously visited facility was higher in children and elderly people, and <50% in people aged 15–60 years. The mean months of visits during the baseline period was <4 months in most facilities, but it was ≥10 months in some facilities, indicating that only those who visited frequently were diagnosed.

CONCLUSIONS: Frequent previous visits may have influenced whether medical facilities accepted patients. The GP system should be one that can improve the unfair situation during the pandemic.