Responding to COVID-19: The Suitability of Primary Care Infrastructure in 33 Countries

Adam Windak; Katarzyna Nessler; Esther Van Poel; Claire Collins; Ewa Wójtowicz; Liubove Murauskiene; Kathryn Hoffmann; Sara Willems

doi:10.3390/ijerph192417015

Responding to COVID-19: The Suitability of Primary Care Infrastructure in 33 Countries

Int J Environ Res Public Health. 2022 Dec 18;19(24):17015. doi: 10.3390/ijerph192417015.

Authors

Adam Windak¹, Katarzyna Nessler¹, Esther Van Poel², Claire Collins^{2

3}, Ewa Wójtowicz¹, Liubove Murauskiene⁴, Kathryn Hoffmann⁵, Sara Willems²

Affiliations

¹ Department of Family Medicine, Jagiellonian University Medical College, 31-061 Krakow, Poland.
² Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium.
³ Research Centre, Irish College of General Practitioners, D02 XR68 Dublin, Ireland.
⁴ Public Health Department, Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania.
⁵ Unit Health Services Research and Telemedicine in Primary Care, Department of Preventive- and Social Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Wien, Austria.

Abstract

COVID-19 proved that primary care (PC) providers have an important role in managing health emergencies, such as epidemics. Little is known about the preparedness of primary care practice infrastructure to continue providing high quality care during this crisis. The aim of this paper is to describe the perceived limitations to the infrastructure of PC practices during COVID-19 and to determine the factors associated with a higher likelihood of infrastructural barriers in providing high quality care. This paper presents the results of an online survey conducted between November 2020 and November 2021 as a part of PRICOV-19 study. Data from 4974 practices in 33 countries regarding perceived limitations and intentions to make future adjustments to practice infrastructure as a result of the COVID-19 pandemic were collected. Approximately 58% of practices experienced limitations to the building or other practice infrastructure to provide high-quality and safe care during the COVID-19 pandemic, and in 54% making adjustments to the building or the infrastructure was considered. Large variations between the countries were found. The results show that infrastructure constraints were directly proportional to the size of the practice. Better pandemic infection control equipment, governmental support, and a fee-for-service payment system were found to be associated with a lower perceived need for infrastructural changes. The results of the study indicate the need for systematic support for the development of practice infrastructure in order to provide high-quality, safe primary care in the event of future crises similar to the COVID-19 pandemic.

Keywords: COVID-19 pandemic; PRICOV-19; general practice; infection prevention and control; infrastructure; pandemic preparedness; patient safety; primary care/family medicine; quality of care.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19* / epidemiology
Humans
Pandemics / prevention & control
Primary Health Care
Quality of Health Care
Surveys and Questionnaires

Grants and funding

The PRICOV-19 data collection was undertaken without funding in individual countries. A small grant was received by Ghent University from the European General Practice Research Network (EGPRN) to cover data cleaning; no grant number applies. The APC for this paper was funded by the first author’s institution—the Jagiellonian University Medical College in Krakow.