Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium.
Research Centre, Irish College of General Practitioners, D02 XR68 Dublin, Ireland.
Int J Environ Res Public Health. 2023 Feb 10;20(4):3165. doi: 10.3390/ijerph20043165.
The COVID-19 pandemic disproportionately affected vulnerable populations' access to health care. By proactively reaching out to them, general practices attempted to prevent the underutilization of their services. This paper examined the association between practice and country characteristics and the organization of outreach work in general practices during COVID-19. 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. 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 possible situation of domestic violence or a child-rearing situation (17.2%). Outreach work was positively related to the availability of an administrative assistant or practice manager ( < 0.05) or paramedical support staff ( < 0.01). Other practice and country characteristics were not significantly associated with undertaking outreach work. Policy and financial interventions supporting general practices to organize outreach work should focus on the range of personnel available to support such practice activities.
COVID-19 大流行使弱势群体获得医疗保健的机会受到不成比例的影响。全科医生通过主动与他们联系，试图防止他们服务的利用不足。本文研究了在 COVID-19 期间，实践和国家特征与全科医生外展工作的组织之间的关联。对来自 38 个国家的 4982 个实践的数据进行了嵌套在实践中的线性混合模型分析。将外展工作的 4 项指标作为结果变量进行构建，在实践和国家层面的信度分别为 0.77 和 0.97。结果表明，许多实践开展了外展工作，包括从电子病历中提取至少一份慢性病患者名单（30.1%）；并对慢性病患者（62.8%）、心理脆弱患者（35.6%）或可能有家庭暴力或育儿情况的患者（17.2%）进行电话外展。外展工作与行政助理或诊所经理（<0.05）或辅助医疗支持人员（<0.01）的可用性呈正相关。其他实践和国家特征与开展外展工作没有显著关联。支持全科医生组织外展工作的政策和财政干预措施应侧重于支持此类实践活动的人员范围。
