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

Poel, Esther Van; Collins, Claire; Groenewegen, Peter; Spreeuwenberg, Peter; Bojaj, Gazmend; Gabrani, Jonila; Mallen, Christian; Murauskienė, Liubovė; Milićević, Milena Šantrić; Schaubroeck, Emmily; Stark, Stefanie; Willems, Sara

doi:10.3390/ijerph20043165

Cited by 6 publications

(4 citation statements)

References 55 publications

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“…However, practices did not frequently reach out to psychologically vulnerable patients or patients with known problems of domestic violence or issues related to raising or parenting a child. Based on the findings of another PRICOV-19 paper, the Belgian numbers were lower than the European average, except for proactive care for patients with a psychological vulnerability [ 30 ]. Setting up outreach work was one of the new tasks within practices during COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Quality of care in Belgian general practices during the COVID-19 pandemic: results of the cross-sectional PRICOV-19 study

Van Poel,

Vanden Bussche,

Pétré

et al. 2024

BMC Prim. Care

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Background The COVID-19 pandemic immensely impacted care provision, including quality of care in general practice. This paper aimed: (1) to assess how Belgian general practices acted upon the six dimensions of quality of care during COVID-19; (2) to study differences between the three Belgian regions; and (3) to benchmark the performance of the Belgian practices against the performance in other European countries. Methods The data collected from 479 Belgian practices during 2020–2021 using an online survey as part of the international cross-sectional PRICOV-19 study were analyzed. Hereby, descriptive statistics, chi-squared tests, and binary logistic regression analyses were performed. Thirty-four survey questions related to the six dimensions of quality of care were selected as outcome variables. The adjusted regression models included four practice characteristics as covariates: practice type, being a teaching practice for GP trainees, multidisciplinarity of the team, and payment system. Results Belgian practices made important organizational changes to deliver high-quality care during COVID-19. Most practices (n = 259; 56.1%) actively reached out to vulnerable patients. Limitations to the practice building or infrastructure threatened high-quality care in 266 practices (55.5%). Infection prevention measures could not always be implemented during COVID-19, such as using a cleaning protocol (n = 265; 57.2%) and providing a separate doctor bag for infection-related home visits (n = 130; 27.9%). Three hundred and sixty practices (82.0%) reported at least one safety incident related to a delayed care process in patients with an urgent condition. The adjusted regression analysis showed limited significant differences between the Belgian regions regarding the quality of care delivered. Belgian practices demonstrated varied performance compared to other European countries. For example, they excelled in always checking the feasibility of isolation at home but reported more patient safety incidents related to timely care than at least three-quarters of the other European countries. Conclusions Future studies using different design methods are crucial to investigate which country and practice characteristics are associated with delivering high-quality care.

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Section: Discussionmentioning

confidence: 99%

Quality of care in Belgian general practices during the COVID-19 pandemic: results of the cross-sectional PRICOV-19 study

Van Poel,

Vanden Bussche,

Pétré

et al. 2024

BMC Prim. Care

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“…Having the tools and the lines of communication to identify vulnerable patients and possessing the necessary skills for population management are indispensable prerequisites for success. PRICOV-19 also showed that outreaching was strongly associated with the availability of an administrative assistant, practice manager, or paramedical support staff, thereby stressing the importance of interprofessional practice teams [ 5 , 6 ].…”

Section: Recommendationsmentioning

confidence: 99%

Moving forward after the COVID-19 pandemic: Lessons learned in primary care from the multi-country PRICOV-19 study

Willems,

Vanden Bussche,

Van Poel

et al. 2024

European Journal of General Practice

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Background The COVID-19 pandemic has accentuated the indispensable role of primary care. Objectives: Recognising this, the PRICOV-19 study investigated how 5,489 GP practices across 38 countries (Austria, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Israel, Italy, Kosovo*, Latvia, Lithuania, Luxembourg, Malta, Republic of Moldova, Netherlands, North Macedonia, Norway, Poland, Portugal, Romania, Serbia, Slovenia, Spain, Sweden, Switzerland, Turkey, Ukraine, and United Kingdom) adapted their care delivery during the pandemic. Methods Based on a series of discussions on the results of the PRICOV-19 study group, eight recommendations to enhance primary care’s preparedness for future crises were formulated and endorsed by EQuiP and WONCA Europe. Results The recommendations underscore the importance of recognising and sustaining the substantial strides made in patient safety within GP practices during the pandemic in current daily practices; acknowledging and supporting the pivotal role of GP practices in addressing health inequalities during crises; adopting interprofessional care models to enhance practices’ resilience and adaptability to change; supporting training practices; creating healthy working environments; investing in infrastructure that supports adequate and safe care; and increasing funding for research on patient safety and primary care quality to inform evidence-based health policies and fostering international knowledge exchange among healthcare professionals and policymakers. Conclusion Policymakers, primary care associations, and the broader healthcare system are urged to collaboratively take responsibility and increase support for GP practices to enhance their resilience, adaptability, and capacity to deliver safe and equitable healthcare during future crises.

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“…Four survey questions regarding outreach initiatives were selected as the outcome variables in the analyses (Table 1). A recent publication of the international PRI-COV-19 consortium regarding the international data on outreach work also used these four items [15]. To determine if these four survey questions captured multiple components related to outreach work, the research team conducted a principal component analysis (PCA) [35].…”

Section: Outcome Measurementioning

confidence: 99%

“…A recent scoping review revealed considerable variability in the conceptualization of outreach work [13]. This paper defines outreach work as proactive, provider-initiated care that goes beyond the typical care provision driven by patient demand [14,15]. Numerous studies have demonstrated the effectiveness of outreach work in promoting continuity of care and providing preventive care for diverse health conditions and demographic groups [14,[16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Outreach work in Belgian primary care practices during COVID-19: results from the cross-sectional PRICOV-19 study

Vanden Bossche,

Van Poel,

Vanden Bussche

et al. 2024

BMC Prim. Care

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Background General practitioners (GPs) have a vital role in reaching out to vulnerable populations during and after the COVID-19 pandemic. Nonetheless, they experience many challenges to fulfill this role. This study aimed to examine associations between practice characteristics, patient population characteristics and the extent of deprivation of practice area on the one hand, and the level of outreach work performed by primary care practices (PCPs) during the COVID-19 pandemic on the other hand. Methods Belgian data from the international PRICOV-19 study were analyzed. Data were collected between December 2020 and August 2021 using an online survey in PCPs. Practices were recruited through randomized and convenience sampling. Descriptive statistics and ordinal logistic regression analyses were performed. Four survey questions related to outreach work constitute the outcome variable. The adjusted models included four practice characteristics (practice type, being a teaching practice for GP trainees; the presence of a nurse or a nurse assistant and the presence of a social worker or health promotor), two patient population characteristics (social vulnerability and medical complexity) and an area deprivation index. Results Data from 462 respondents were included. First, the factors significantly associated with outreach work in PCPs are the type of PCP (with GPs working in a group performing more outreach work), and the presence of a nurse (assistant), social worker or health promotor. Second, the extent of outreach work done by a PCP is significantly associated with the social vulnerability of the practice’s patient population. This social vulnerability factor, affecting outreach work, differed with the level of medical complexity of the practice’s patient population and with the level of deprivation of the municipality where the practice is situated. Conclusions In this study, outreach work in PCPs during the COVID-19 pandemic is facilitated by the group-type cooperation of GPs and by the support of at least one staff member of the disciplines of nursing, social work, or health promotion. These findings suggest that improving the effectiveness of outreach efforts in PCPs requires addressing organizational factors at the practice level. This applies in particular to PCPs having a more socially vulnerable patient population.

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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

Cited by 6 publications

References 55 publications

Quality of care in Belgian general practices during the COVID-19 pandemic: results of the cross-sectional PRICOV-19 study

Quality of care in Belgian general practices during the COVID-19 pandemic: results of the cross-sectional PRICOV-19 study

Moving forward after the COVID-19 pandemic: Lessons learned in primary care from the multi-country PRICOV-19 study

Outreach work in Belgian primary care practices during COVID-19: results from the cross-sectional PRICOV-19 study

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