The Organization of Outreach Work for Vulnerable Patients in General Practice during COVID-19: Results from the Cross-Sectional PRICOV-19 Study in 38 Countries

Int J Environ Res Public Health. 2023 Feb 10;20(4):3165. doi: 10.3390/ijerph20043165.

Abstract

The COVID-19 pandemic disproportionately affected vulnerable populations' access to health care. By proactively reaching out to them, general practices attempted to prevent the underutilization of their services. This paper examined the association between practice and country characteristics and the organization of outreach work in general practices during COVID-19. Linear mixed model analyses with practices nested in countries were performed on the data of 4982 practices from 38 countries. A 4-item scale on outreach work was constructed as the outcome variable with a reliability of 0.77 and 0.97 at the practice and country level. The results showed that many practices set up outreach work, including extracting at least one list of patients with chronic conditions from their electronic medical record (30.1%); and performing telephone outreach to patients with chronic conditions (62.8%), a psychological vulnerability (35.6%), or possible situation of domestic violence or a child-rearing situation (17.2%). Outreach work was positively related to the availability of an administrative assistant or practice manager (p < 0.05) or paramedical support staff (p < 0.01). Other practice and country characteristics were not significantly associated with undertaking outreach work. Policy and financial interventions supporting general practices to organize outreach work should focus on the range of personnel available to support such practice activities.

Keywords: COVID-19; PRICOV-19; community-oriented primary care; equity; general practice; international comparison; outreach work; primary health care; quality of care; vulnerable populations.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • COVID-19*
  • Chronic Disease
  • Cross-Sectional Studies
  • General Practice*
  • Humans
  • Pandemics
  • Reproducibility of Results

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 King Baudouin Foundation (Belgium).