Abstract
Background
During the COVID-19 pandemic, the majority of patients received ambulatory treatment, highlighting the importance of primary health care (PHC). However, there is limited knowledge regarding PHC workload in Europe during this period. The utilization of COVID-19 PHC indicators could facilitate the efficient monitoring and coordination of the pandemic response. The objective of this study is to describe PHC indicators for disease surveillance and monitoring of COVID-19’s impact in Europe.
Methods
Descriptive, cross-sectional study employing data obtained through a semi-structured ad hoc questionnaire, which was collectively agreed upon by all participants. The study encompasses PHC settings in 31 European countries from March 2020 to August 2021. Key-informants from each country answered the questionnaire. Main outcome: the identification of any indicator used to describe PHC COVID-19 activity.
Results
Out of the 31 countries surveyed, data on PHC information were obtained from 14. The principal indicators were: total number of cases within PHC (Belarus, Cyprus, Italy, Romania and Spain), number of follow-up cases (Croatia, Cyprus, Finland, Spain and Turkey), GP’s COVID-19 tests referrals (Poland), proportion of COVID-19 cases among respiratory illnesses consultations (Norway and France), sick leaves issued by GPs (Romania and Spain) and examination and complementary tests (Cyprus). All COVID-19 cases were attended in PHC in Belarus and Italy.
Conclusions
The COVID-19 pandemic exposes a crucial deficiency in preparedness for infectious diseases in European health systems highlighting the inconsistent recording of indicators within PHC organizations. PHC standardized indicators and public data accessibility are urgently needed, conforming the foundation for an effective European-level health services response framework against future pandemics.
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; Guisado-Clavero, Marina 2 ; Lourdes Ramos Del Rio 3
; Larrondo, Ileana Gefaell 3 ; Fitzgerald, Louise 4
; Murauskienė, Liubovė 5
; Naldy Parodi López 6
; Perjés, Ábel 7
; Petek, Davorina 8
; Petrazzuoli, Ferdinando 9
; Petricek, Goranka 10
; Sattler, Martin 11 ; Saurek-Aleksandrovska, Natalija 12 ; Senn, Oliver 13
; Seifert, Bohumil 14
; Serafini, Alice 15
; Sentker, Theresa 16
; Ticmane, Gunta 17 ; Tiili, Paula 18
; Torzsa, Péter 7
; Valtonen, Kirsi 19 ; Vaes, Bert 20
; Vinker, Shlomo 21
; Adler, Limor 22
; Assenova, Radost 23
; Bakola, Maria 24
; Bayen, Sabine 25
; Brutskaya-Stempkovskaya, Elena 26 ; Iliana-Carmen Busneag 27 ; Divjak, Asja Ćosić 28 ; Maryher Delphin Peña 29 ; Díaz, Esperanza 30 ; Philippe-Richard Domeyer 31
; Feldmane, Sabine 32 ; Gjorgjievski, Dragan 33 ; Gómez-Johansson, Mila 34 ; Ángel Gónzalez de la Fuente 35
; Hanževački, Miroslav 10 ; Hoffmann, Kathryn 36
; Ільков, Оксана 37
; Shushman Ivanna 37
; Jandrić-Kočić, Marijana 38 ; Karathanos, Vasilis Trifon 39
; Üçüncü, Erva Kirkoç 40 ; Kirkovski, Aleksandar 41
; Knežević, Snežana 42
; Büsra Çimen Korkmaz 43
; Kostić, Milena 44 ; Krztoń-Królewiecka, Anna 45 ; Kozlovska, Liga 46 ; Nessler, Katarzyna 47
; Gómez-Bravo, Raquel 48 ; María Pilar Astier Peña 49
; Lingner, Heidrun 16
1 Federica Montseny Health Centre, Gerencia Asistencial Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain; Medical Specialties and Public Health, School of Health Sciences, University Rey Juan Carlos, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón , Madrid, Spain
2 Investigation Support Multidisciplinary Unit for Primary care and Community North Area of Madrid, Gerencia Asistencial Atención Primaria, Servicio Madrileño de Salud , Madrid, Spain
3 Federica Montseny Health Centre, Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud , Madrid, Spain
4 Member of Irish College of General Practice (MICGP), Member of Royal College of Physician (MRCSI) , Dublin, Ireland
5 Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University , Vilnius, Lithuania
6 Närhälsan Kungshöjd Health Centre, Gothenburg, Sweden; Department of Pharmacology, Sahlgrenska Academy, University of Gothenburg , Gothenburg, Sweden
7 Department of Family Medicine at the University of Semmelweis , Budapest, Hungary
8 Department of Family Medicine, Faculty of Medicine, University of Ljubljana , Ljubljana, Slovenia
9 Department of Clinical Sciences in Malmö, Centre for Primary Health Care Research, Lund University , Malmö, Sweden
10 Department of Family Medicine “Andrija Stampar” School of Public Health, School of Medicine, University of Zagreb, Croatia; Health Centre Zagreb West , Croatia
11 European Parliament , Luxembourg, Luxembourg
12 PZU Femilihelt , Skopje, North Macedonia
13 Institute of Primary Care, University of Zurich and University Hospital Zurich , Zurich, Switzerland
14 Charles University, First Faculty of Medicine, Institute of General Practice , Prague, Czech Republic
15 Azienda Unità Sanitaria Locale di Modena, Laboratorio EduCare, University of Modena and Reggio Emilia , Modena, Italy
16 Center for Public Health and Healthcare, Hannover Medical School , Hannover, Germany
17 Department of Family Medicine at Riga Stradiņš University, Riga, Latvia; Member of the board of the Rural Family Doctors’ Association of Latvia , Latvia
18 Communicable Diseases and Infection Control Unit, City of Vantaa, Vantaa. University of Helsinki , Helsinki, Finland
19 Communicable Diseases and Infection Control Unit, City of Vantaa , Vantaa, Finland
20 Department of Public Health and Primary Care, KU Leuven , Leuven, Belgium
21 Department of Family Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. WONCA Europe President , Israel
22 Department of Family Medicine, Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel
23 Department Urology and General Practice, Faculty of Medicine, Medical University of Plovdiv , Plovdiv, Bulgaria
24 Research Unit for General Medicine and Primary Health Care, Faculty of Medicine, School of Health Science, University of Ioannina , Ioannina, Greece
25 Department of General Practice, University of Lille , Lille, France
26 General Medicine Department, Belarusian State Medical University , Minsk, Belarus
27 Kinetic Therapy and Special Motricity, “Spiru Haret” University , Bucharest, Romania
28 Health Centre Zagreb Centar , Zagreb, Croatia
29 Department of Geriatric Medicine, Hôpitaux Robert Schuman , Luxembourg, Luxembourg
30 Pandemic Center, Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway; Norwegian National Institute of Public Health , Bergen, Norway
31 School of Social Sciences, Hellenic Open University , Patra, Greece
32 Department of Family Medicine, Rīga Stradins University , Riga, Latvia
33 Center for family medicine, Medical faculty Skopje , Skopje, North Macedonia
34 Närhälsan Sannegården Health Centre , Gothenburg, Sweden
35 UCL Global Business School for Health, London , UK
36 Department of General Practice and Primary Care, Med. University of Vienna , Vienna, Austria
37 Department of Family Medicine and Outpatient Care, Medical Faculty 2, Uzhhorod National University , Uzhhorod, Ukraine
38 Health center Krupa na Uni, Krupa na Uni,Republic of Srpska, Bosnia and Herzegovina
39 Laboratory of Hygiene and Epidemiology, Medical Department, Faculty of Health Sciences, University of Ioannina- Greece; GHS , Larnaca, Cyprus
40 Department of Family Medicine , Prof. Dr Cemil Tascioglu City Hospital, Istanbul, Turkey
41 Faculty of Medicine, Ss. Cyril and Methodius University , Skopje, North Macedonia
42 Health center Kraljevo , Kraljevo, Serbia
43 Van Gürpınar District Public Hospital , Van Gürpınar, Turkey
44 Health Center “Dr Đorđe Kovačević ”, Lazarevac, Belgrade, Serbia
45 Department of Family Medicine, Andrzej Frycz Modrzewski Krakow University , Krakow, Poland
46 Department of Family Medicine of Riga Stradins University, Riga, Latvia; President of the Rural Family Doctors' Association of Latvia
47 Department of Family Medicine UJCM at Uniwersytet Jagielloński - Collegium Medicum , Kraków, Poland
48 CHNP, Rehaklinik, Ettelbruck, Luxembourg; Research Group Self-Regulation and Health, Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, Faculty of Humanities, Education, and Social Sciences, Luxembourg University , Luxembourg , Luxembourg
49 Technical Advisor for Quality and Safety, Territorial Healthcare Quality Unit, Territorial Healthcare Direction of Camp de Tarragona, Healthcare Institut of Catalonia, Health Departament, Generalitat de Catalunya GIBA-IIS-Aragón, Catalunya, Spain; Chair of Patient Safety Working Party of semFYC (Spanish Society for Family and Community Medicine) and Quality and Safety in Family Medicine of WONCA World (Global Family Doctors), Board Member of WONCA World and SECA (Spanish Society for Healthcare Quality) , Spain





