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Impact of the COVID-19 pandemic on the core functions of primary care: will the cure be worse than the disease? A qualitative interview study in Flemish GPs.
Verhoeven, Veronique; Tsakitzidis, Giannoula; Philips, Hilde; Van Royen, Paul.
  • Verhoeven V; Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerpen, Belgium veronique.verhoeven@uantwerpen.be.
  • Tsakitzidis G; Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerpen, Belgium.
  • Philips H; Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerpen, Belgium.
  • Van Royen P; Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerpen, Belgium.
BMJ Open ; 10(6): e039674, 2020 06 17.
Article in English | MEDLINE | ID: covidwho-608159
ABSTRACT

OBJECTIVES:

The current COVID-19 pandemic, as well as the measures taken to control it, have a profound impact on healthcare. This study was set up to gain insights into the consequences of the COVID-19 outbreak on the core competencies of general practice, as they are experienced by general practitioners (GPs) on the frontline. DESIGN, SETTING,

PARTICIPANTS:

We performed a descriptive study using semistructured interviews with 132 GPs in Flanders, using a topic list based on the WONCA definition of core competencies in general practice. Data were analysed qualitatively using framework analysis.

RESULTS:

Changes in practice management and in consultation strategies were quickly adopted. There was a major switch towards telephone triage and consults, for covid-related as well as for non-covid related problems. Patient-centred care is still a major objective. Clinical decision-making is largely focused on respiratory assessment and triage, and GPs feel that acute care is compromised, both by their own changed focus and by the fact that patients consult less frequently for non-covid problems. Chronic care is mostly postponed, and this will have consequences that will extend and become visible after the corona crisis. Through the holistic eyes of primary care, the current outbreak-as well as the measures taken to control it-will have a profound impact on psychological and socioeconomic well-being. This impact is already visible in vulnerable people and will continue to become clear in the medium and long terms. GPs think that they are at high risk of getting infected. Dropping out and being unable to contribute their part or becoming virus transmitters are reported to be greater concerns than getting ill themselves.

CONCLUSIONS:

The current times have a profound impact on the core competences of primary care. Although the vast increase in patients soliciting medical help and the necessary separate covid and non-covid flows have been dealt with, GPs are worried about the continuity of regular care and the consequences of the anticovid measures. These may become a threat for the general health of the population and for the provision of primary healthcare in the near and distant future.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Primary Health Care / Attitude of Health Personnel / Coronavirus Infections / General Practitioners / Clinical Decision-Making Type of study: Experimental Studies / Prognostic study / Qualitative research Topics: Traditional medicine Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: BMJ Open Year: 2020 Document Type: Article Affiliation country: Bmjopen-2020-039674

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Primary Health Care / Attitude of Health Personnel / Coronavirus Infections / General Practitioners / Clinical Decision-Making Type of study: Experimental Studies / Prognostic study / Qualitative research Topics: Traditional medicine Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: BMJ Open Year: 2020 Document Type: Article Affiliation country: Bmjopen-2020-039674