Resilience of primary health care facilities - experiences from 16 European countries during the Covid-19 pandemic. A mixed-methods study conducted by EURIPA.

Resilience of primary health care facilities – experiences from 16 European countries during the Covid-19 pandemic. A mixed-methods study conducted by EURIPA.

Abstract

Background

The role of primary care during a pandemic varies across European countries. The COVID-19 pandemic has altered the working practices of family medicine doctors. It has also impacted the resilience of health systems.

Objectives

This study aimed to examine European health system responses to the pandemic, focusing on rural and urban differences.

Material and methods

This cross-sectional, mixed-methods study used a semi-structured online questionnaire with 68 questions, including 21 free-text comments. Data were collected from May 2020 to January 2021. Key informants from sixteen EURIPA member countries distributed questionnaires to 406 primary care doctors. Data were analyzed using descriptive statistics and non-parametric tests (Chi-square, Kruskal-Wallis, Mann-Whitney U) with a significance threshold of 0.05.

Results

A statistically significant difference was found between rural (36.4%, 55/151), semirural (19.4%, 24/124), and urban populations (29.8%, 39/131) regarding medicine shortages (χ² = 9.91, df = 4, p = 0.042).  The semirural one proved to have a statistically significant difference with the other settings(chi-square post-hoc test, p = 0.004 in post-hoc chi-square test). Significant differences were found between countries in resilience features including, Effectiveness of triage, Adapting to the rapidly changing requirements, Government help, Existence of a community resilience group, Improved interprofessional collaboration, Medicine Shortage and GPs involved in palliative care.

Conclusions

Medicine shortage was more prevalent in rural and urban areas compared to semirural ones. Differences were observed between countries in their responses to the pandemic, particularly in Adapting to the rapidly changing requirements, Effectiveness of triage, Government help, Existence of a Community resilience group. Qualitative analysis confirmed these disparities.

The results emphasize the need for tailored approaches considering diverse contexts in shaping effective health system resilience.