Post-COVID Trajectories of Public Primary Healthcare Activity in Greece: Evidence from a 10-Year National Facility-Level Panel (2015–2024)

Background/Objectives: The Greek public primary healthcare (PHC) system underwent successive structural reforms between 2014 and 2024, while the COVID-19 pandemic profoundly disrupted service delivery. Despite the availability of nationwide administrative data, there is limited longitudinal evidence on how public PHC activity evolved during the post-pandemic period. Using ten years (2015–2024) of routinely collected data from the Greek Ministry of Health’s Business Intelligence system (BI-Health), we examined post-2019 changes in recorded activity among eligible facilities reporting in 2019, alongside annual activity totals and reporting coverage in the evolving public PHC network. Methods: We conducted a retrospective observational study of annual facility-level administrative data submitted by public PHC facilities through the BI-Forms subsystem of BI-Health, using the facility-year as the unit of analysis. Facility-level changes were estimated using conditional fixed-effects Poisson panel models with standard errors clustered by facility and 2019 as the reference year. The outcomes represent recorded facility activity rather than population-level utilisation. Results: Reporting facilities increased from 461 in 2015 to 653 in 2024. However, changes in recorded activity differed substantially across visit categories. Emergency visits declined sharply during 2020–2021 but approached their 2019 level by 2024 (IRR 0.989, 95% CI 0.927–1.054). Regular visits, however, remained persistently reduced throughout the post-pandemic period (2024 IRR 0.787, 95% CI 0.749–0.826), corresponding to recorded activity approximately one-fifth below 2019 levels in 2024 within the primary regular-visit cohort. The 2024 point estimate for prescription-only visits was modestly below 2019 (IRR 0.944, 95% CI 0.880–1.012). Conclusions: These findings suggest that, although recorded emergency activity approached its 2019 level, scheduled public primary-care activity remained lower. Beyond documenting post-pandemic activity patterns, this study demonstrates the value of national longitudinal administrative data for monitoring changes in recorded service activity, with potential applications in service planning. Building on this approach, it also highlights the potential value of a systematic framework to inform decisions in primary healthcare.