Active outreach to vulnerable patients during COVID-19: a common practice or exception in primary health care?

Esther Van Poel, Claire Collins, Maria Vanden Muijsenbergh, Peter Groenewegen, Emmily Schaubroeck, Stefanie Stark, Victoria Tkachenko, Isabelle Dupie, Hector Falcoff, Liubové Murauskiene, Sara Willems

Keywords: primary health care, general practice, equity, community medicine, outreach work, patient safety, quality of care, PRICOV-19, COVID-19

Introduction:
The COVID-19 pandemic led directly and indirectly to an increased number of vulnerable population groups. General practitioners (GPs) were in the best position to identify vulnerable patients and limit the growth of health inequities. However, COVID-19 confronted GP practices with unprecedented structural and organizational challenges to provide high-quality care. Did GPs in Europe succeed in setting up outreach activities for maintaining their key role?

Method:
We used data from the PRICOV-19 study among GP practices in 38 European countries for the analyses. A scale on active outreach was constructed based on six items as the outcome variable. Using the software MLWin, multilevel Poisson analyses were performed on GP practices nested in countries.

Results:
The results showed a reliable 6-item scale on active outreach with an internal consistency coefficient of 0.69 (Cronbach alpha). According to preliminary analysis (using 2nd order PQL estimation) on 3,928 GP practices, the following practice characteristics were significantly negatively associated with the setup of outreach activities: monodisciplinarity (versus multidisciplinarity) and being a solo or duo GP practice (versus being a group practice). In addition, outreach activities were significantly more common in GP practices with above-average patients with chronic disorders.

Conclusions:
Further analyses are needed to verify and elaborate the current statements.

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