The role of primary care during the pandemic: shared experiences from providers in five European countries

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  • Markus Kraus
  • Christoph Stegner
  • Miriam Reiss
  • Monika Riedel
  • Børsch, Anne Sofie
  • Vrangbæk, Karsten
  • Morgane Michel
  • Kathleen Turmaine
  • Borbála Cseh
  • Csaba László Dózsa
  • Roberto Dandi
  • Angelo Rossi Mori
  • Thomas Czypionka

Background: The COVID-19 pandemic necessitated wide-ranging adaptations to the organisation of health systems, and primary care is no exception. This article aims to collate insights on the role of primary care during the pandemic. The gained knowledge helps to increase pandemic preparedness and resilience. Methods: The role of primary care during the pandemic in five European countries (Austria, Denmark, France, Hungary, Italy) was investigated using a qualitative approach, namely case study, based on document analysis and semi-structured interviews. In total, 31 interviews were conducted with primary care providers between June and August 2022. The five country case studies were subjected to an overarching analysis focusing on successful strategies as well as gaps and failures regarding pandemic management in primary care. Results: Primary care providers identified disruptions to service delivery as a major challenge emerging from the pandemic which led to a widespread adoption of telehealth. Despite the rapid increase in telehealth usage and efforts of primary care providers to organise face-to-face care delivery in a safe way, some patient groups were particularly affected by disruptions in service delivery. Moreover, primary care providers perceived a substantial propagation of misinformation about COVID-19 and vaccines among the population, which also threatened patient-physician relationships. At the same time, primary care providers faced an increased workload, had to work with insufficient personal protective equipment and were provided incongruous guidelines from public authorities. There was a consensus among primary care providers that they were mostly sidelined by public health policy in the context of pandemic management. Primary care providers tackled these problems through a diverse set of measures including home visits, implementing infection control measures, refurbishing used masks, holding internal meetings and relying on their own experiences as well as information shared by colleagues. Conclusion: Primary care providers were neither well prepared nor the focus of initial policy making. However, they implemented creative solutions to the problems they faced and applying the learnings from the pandemic could help in increasing the resilience of primary care. Attributes of an integrated health system with a strong primary care component proved beneficial in addressing immediate effects of the pandemic.

OriginalsprogEngelsk
Artikelnummer1054
TidsskriftBMC Health Services Research
Vol/bind23
Udgave nummer1
Antal sider20
ISSN1472-6963
DOI
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
This research is part of the PERISCOPE project (Pan-European Response to the ImpactS of COVID-19 and future Pandemics and Epidemics; https://periscopeproject.eu ), a research project funded by the Horizon 2020 programme of the European commission. Among others, the project aims to analyse preparedness and adaptive capacity of health systems with regards to COVID-19, assess the impact of the outbreak and policy measures on health systems and draw lessons from these experiences to improve health system resilience. Different definitions of health system resilience have been put forward, which the World Health Organization (WHO) [] summarises as ‘the ability of all actors and functions related to health to collectively mitigate, prepare, respond and recover from disruptive events with public health implications, while maintaining the provision of essential functions and services and using experiences to adapt and transform the system for improvement’. For an in-depth discussion on resilience see, for example, OECD [] or WHO []. For the purpose of our analysis, resilience is referring to the COVID-19 pandemic as the disruptive event, serious threat or hazard.

Funding Information:
The PERISCOPE project was funded by the European Union’s Horizon2020 research and innovation programme, PERISCOPE: Pan European Response to the Impacts of Covid-19 and future Pandemics and Epidemics, under grant agreement No. 101016233, H2020-SC1-PHE CORONAVIRUS-2020-2-RTD. The funder does not influence any part of the research process. The content of this article reflects only the PERISCOPE group’s views and the European Commission is not liable for any use that may be made of the information contained herein.

Publisher Copyright:
© 2023, BioMed Central Ltd., part of Springer Nature.

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