Van Poel Esther, van Loenen Tessa, Collins Claire, Van Roy Kaatje, Van den Muijsenbergh Maria, Willems Sara
Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium.
Quality and Safety Ghent, Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium.
Healthcare (Basel). 2023 Nov 21;11(23):3009. doi: 10.3390/healthcare11233009.
Addressing equity in healthcare is fundamental for delivering safe care to vulnerable patients, especially during COVID-19. This paper aims to identify barriers and enabling factors for general practitioners (GPs) in delivering safe and equitable care during the COVID-19 pandemic. Semi-structured interviews took place during May-July 2020 among 18 Flemish and 16 Dutch GPs. Thematic analysis of the interviews demonstrated that while GPs acknowledged a smooth information flow by governments and professional organizations on care guidelines, the fast-changing information challenged them to stay up to date. Media communication facilitated information dissemination but also fueled misinformation and miscommunication, creating unrealistic patient expectations. Certain guidelines and patient reluctance delayed necessary care. A shortage of personal protective equipment made GPs concerned about patient safety during face-to-face contacts. Teleconsultations became a popular alternative, but posed increased patient safety risks. GPs struggled to identify and reach vulnerable patients. Equitable care was hindered by time constraints; thus, having the appropriate materials facilitated such care. An interprofessional collaboration involving paramedical, social, and city services benefited patient safety and equity in healthcare. However, limitations in this collaboration pressured GPs. The unprecedented and resource-constrained environment challenged GPs' capacity to provide the healthcare quality they aspired to deliver. A well-structured collaborative network involving all stakeholders could benefit safe and equitable care in future pandemics.
在医疗保健中解决公平问题对于为脆弱患者提供安全护理至关重要，尤其是在新冠疫情期间。本文旨在确定全科医生（GPs）在新冠疫情期间提供安全和公平护理的障碍及促成因素。2020年5月至7月期间，对18名弗拉芒语区和16名荷兰语区的全科医生进行了半结构化访谈。访谈的主题分析表明，虽然全科医生认可政府和专业组织在护理指南方面信息流通顺畅，但快速变化的信息使他们难以跟上最新情况。媒体传播促进了信息传播，但也助长了错误信息和沟通不畅，导致患者产生不切实际的期望。某些指南和患者的不情愿延误了必要的护理。个人防护设备短缺使全科医生在面对面接触时担心患者安全。远程会诊成为一种受欢迎的替代方式，但增加了患者安全风险。全科医生难以识别和联系脆弱患者。时间限制阻碍了公平护理；因此，拥有适当的材料有助于提供此类护理。涉及辅助医疗、社会和城市服务的跨专业合作有利于患者安全和医疗保健公平。然而，这种合作的局限性给全科医生带来了压力。前所未有的资源受限环境挑战了全科医生提供他们渴望提供的医疗质量的能力。一个结构良好的、涉及所有利益相关者的合作网络可能有利于未来疫情期间的安全和公平护理。
