Telemedicine in polish primary care during and after the COVID-19 crisis: a retrospective analysis of over 720,000 consultations.

Background: The COVID-19 pandemic fundamentally reshaped healthcare delivery worldwide, accelerating the adoption of telemedicine. This study aimed to examine patterns of teleconsultation use in Polish primary care across pandemic and post-pandemic phases. Methods: We retrospectively analysed anonymized medical records from a nationwide primary care network (N = 54,430 patients; 720,133 consultations, January 2020-December 2024). The dataset comprised 507,668 in-person visits (70.5%) and 212,465 teleconsultations (29.5%). Variables included patient age, sex, consultation type, and clinical actions (prescriptions, referrals, diagnostic tests). Results: Teleconsultations accounted for 29.5% of all visits (n = 212,465). Before the pandemic, all consultations were in-person, whereas during lockdown teleconsultations peaked at 78.5% (n = 35,840). Their share declined to 65.1% in the first wave and 18.5% in the second wave, then stabilized at 11.8% (n = 18,223) during the state of epidemic threat and 14.9% (n = 32,153) in the post-COVID phase. Differences between periods were statistically significant (e.g., lockdown vs. pre-COVID: χ 2 = 46,451.9, p < 0.001; post-COVID vs. pre-COVID: χ 2 = 5,454.5, p < 0.001). Younger and middle-aged adults used teleconsultations proportionally more often than those ≥60 years, who consistently preferred in-person care. Remote visits were more frequently associated with prescription issuance, whereas in-person consultations more often involved diagnostic tests or specialist referrals. Conclusion: Teleconsultations surged to nearly 80% of visits during lockdown and stabilized at 12-15% post-pandemic. Persistent demographic disparities and modality-specific clinical profiles highlight the need for tailored strategies, strengthened digital infrastructure, and clear guidelines to ensure safe and equitable integration of telemedicine into routine primary care.