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Cited by 30COVID-19 and healthcare impactsPrimary Care and Health OutcomesHealthcare Systems and Challenges

The impact of the COVID-19 pandemic on the continuity of care for at-risk patients in Swiss primary care settings: A mixed-methods study

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Deml, Michael J., Minnema, Julia, Dubois, Julie, Senn, Oliver, Streit, Sven, Rachamin, Yael, Jungo, Katharina Tabea·2022·Social Science & Medicine
DOI 10.1016/j.socscimed.2022.114858PMC PMC8868005
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Abstract

Continuity of care is important for the health of aging individuals with comorbidities. When initial coronavirus mitigation campaigns involved messaging such as "Stay at home-stay safe," and banned provision of non-urgent care, at-risk patients depending upon regular consultations with general practitioners (GPs) faced confusion about the possibility of seeking non-COVID-19 related healthcare. We employed a sequential explanatory mixed-methods design, consisting of a quantitative component followed by a qualitative component, to understand at-risk patients' health services use during the COVID-19 pandemic in Switzerland. Quantitatively, we used electronic medical records data from 272 GPs and 266,796 patients. Based on pre-pandemic data, we predicted weekly consultation counts as well as weekly measurement counts (blood pressure, glycated hemoglobin, and low-density lipoprotein cholesterol) per 100 patients that would be expected in 2020 in absence of a pandemic and compared those to actual observed values. Qualitatively, we conducted 23 semi-structured interviews with 24 GPs (∼45 min) and 37 interviews with at-risk patients (∼35 min). Quantitative results demonstrate a significant decrease in consultation and measurement counts during the first shutdown period, with consultation counts quickly returning to normal and moving within expected values for the rest of 2020. Qualitative data contextualize these findings with GPs describing constantly implementing material, administrative, and communication changes. GPs reported communication gaps with the authorities and noted a lack of clear guidelines delineating how to define "at-risk patients" and what cases were "urgent" to treat during shutdowns. Patient interviews show that patient-level factors, such as fear of contracting coronavirus, perceptions that GPs were overburdened, and a sense of solidarity, influenced patients' decisions to consult less at the beginning of the pandemic. Findings demonstrate communication gaps during pandemic periods and provide valuable lessons for future pandemic preparedness, particularly the need for contingency plans for the overall healthcare system instead of plans focusing only on the infectious agent itself.

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  • Telemedicine is not yet provided everywhere nor with continuity.

    “This continued at least until the start of telemedicine which is not jet provided everywhere nor with continuity [29, 56].”

    From Life Experiences in Neuromuscular Tracheotomized Patients in Times of Covid-19 (2023) · cites this paper as [56]

    The Results (Qualitative component; page unavailable) say sampled patients could consult their GPs by phone and did not perceive a discontinuity of care. The Conclusion (page unavailable) suggests the pandemic may have expanded telemedicine, but neither passage assesses whether telemedicine was available everywhere or provided continuously. Searched for telemedicine availability and continuity. (LLM, conf=0.73)

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Authors
Deml, M. J., Minnema, J., Dubois, J., Senn, O., Streit, S., Rachamin, Y., & Jungo, K. T.
Affiliations
  • University of Geneva (CH)
  • University of Bern (CH)
  • University of Fribourg (CH)
  • University of Zurich (CH)
Corresponding author
Jungo, Katharina Tabea
ORCID
Venue
Social Science & Medicine
Publisher
Elsevier BV
Published
2022-04
Volume
298
Pages
114858
ISSN
0277-9536 (ISSN-L)
DOI
10.1016/j.socscimed.2022.114858
PMC
PMC8868005
OpenAlex
W4213426061
Cited by
30
References
39
Citations by year
2026: 1 · 2025: 4 · 2024: 6 · 2023: 14 · 2022: 5
FWCI
3.03
Type
journal article
Language
en
Open access
Licence
Locations
  • Social Science & Medicine (publishedVersion, cc-by)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Archive ouverte UNIGE (University of Geneva) (publishedVersion, other-oa)
  • Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, cc-by)
  • RePEc: Research Papers in Economics (submittedVersion)
  • Bern Open Repository and Information System (University of Bern) (submittedVersion, cc-by)
  • Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion, cc-by)
  • Open Access CRIS of the University of Bern
  • Zurich Open Repository and Archive (University of Zurich)
Funders
  • National Science Foundation
  • Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
  • Université de Genève
Topics
  • Health Sciences › Medicine › Oncology › COVID-19 and healthcare impacts
  • Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
  • Health Sciences › Health Professions › General Health Professions › Healthcare Systems and Challenges
Keywords
COVID-19 pandemic, continuity of care, at-risk patients, primary care, general practitioners, consultation rates, health care utilization, blood pressure monitoring, HbA1c, LDL cholesterol, pandemic preparedness, patient decision-making
MeSH terms
COVID-19, Continuity of Patient Care, Humans, Primary Health Care, Switzerland, Pandemics

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