Healthcare utilisation in the era of COVID-19 and beyond.:A population-based perspective

The primary aim of this thesis is to examine healthcare utilisation during the COVID-19 pandemic, with a particular focus on understanding patterns of healthcare-seeking behaviour and identifying strategies to enhance public health emergency preparedness. In Chapter 2, I investigate healthcare avoidance during the first wave of the COVID-19 pandemic in the Netherlands (March-June 2020) and evaluate the consequences of this behaviour for population health. These studies examine how individuals adjusted their healthcare-seeking behaviour during this period. In Chapter 3, I shift focus to the perspective of healthcare delivery. This includes analysing changes in consultation rates and exploring patient perspectives on remote types of healthcare, particularly telemedicine, which became a central component of healthcare provision during the COVID-19 pandemic. In Chapter 4, I draw lessons from the COVID-19 pandemic based on experiences in various European countries regarding healthcare utilisation, healthcare delivery, and research practices. These are translated into recommendations for future public health emergency preparedness. Additionally, I evaluate existing multimorbidity prediction models and their potential application in assessing the burden of multimorbidity on healthcare systems. Finally, in Chapter 5, I reflect on my findings, address methodological considerations, and outline future research directions informed by the studies presented in this thesis.