Organizing outreach work for vulnerable patients in general practice during COVID-19: results from the cross-sectional PRICOV-19 study in 38 countries

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

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

Background:

Vulnerable populations in need of care often experience barriers to accessing health care, which have become even worse since COVID-19. By proactively reaching out to them, general practices attempted to prevent the underutilization of their services.

Research questions:

(i) To what extent have general practices set up outreach work during the COVID-19 pandemic? (ii) How can we explain the variability of outreach work based on the practice and country characteristics?

Method:

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.

Results:

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 difficult situation of domestic violence or parenting (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). No other practices or country characteristics were significantly associated with undertaking outreach activities.

Conclusions:

Policy and financial interventions supporting general practices to organize outreach work should focus on the range of personnel available to support such practice activities.

Points for discussion:

Are the study findings recognizable for your country/neighborhood?

What do you think is needed to support general practices to organize outreach work?