Assessing the performance of Hungary’s primary health care system during the COVID-19 pandemic: findings from the cross-sectional PRICOV-19 study
摘要
Primary care (PC) has played a crucial role in the fight against the COVID-19 epidemic. The novel challenges have significantly increased the workload for PC workers, leading to negative impacts on their mental health. Hungarian primary care is in the early stage of moving from solo practices to primary health care teams, while the number of elderly physicians increases quickly. The PRICOV-19 study is a multicenter study in 38 countries that comprehensively assesses the performance of PC during the pandemic. This article focuses on the impact of COVID-19 epidemic on resilience and adaptability of PC in Hungary, during the time of structural change.
MethodsThe questionnaire was sent online to PC practices between April and August 2021 as email links. The 53 questions of the survey were structured around six themes: infection control, patient flow, information acquisition (protocols and knowledge acquisition), patient communication, collegial cooperation, and quality of life of the care workers. To measure the well-being of care workers, the validated Mayo Clinic Wellbeing Index was used.
ResultsRespondents of the study reported notable limitations to their work environment (91, 4%). In response to these challenges, there was a significant increase in implementation of telemedicine rising from 15.3% before COVID to 36.7%. Almost all PC workers reported a substantial surge in their workload during the pandemic (96.7%). Furthermore, many of them (37.8%) expressed the need for additional training to manage the unprecedented challenges posed by the pandemic. These new tasks had a worrisome impact on PC workers, with 55.2% of respondents expressing concern about the increased workload, and 69% experienced some degree of distress. Longer work experience was associated with better adaptation and better quality of life.
ConclusionThe COVID-19 pandemic brought a substantial change in primary car in Hungary, in terms of patient flow, information exchange and communication. While the feeling of being not prepared and lower well-being was common among GPs, adaptation in task shifting and protocol driven telemedicine appeared, especially among more experienced physicians. The process of adjustment in challenging times could be fostered by unambiguous central measurements and through adequate training.