Challanges in providing safe and effective care in Croatian family medicine practices during COVID-19 pandemic: results from the PRICOV-19 study

Zlata Ozvacic Adzic, Venija Cerovecki, Goranka Petricek, Miroslav Hanzevacki, Ino Kermc, Barbara Tomic, Natasa Buljan, Milan Milosevic, Esther Van Poel, Sara Willems

Keywords: primary health care, family practice, quality of health care, patient safety, COVID-19, PRICOV-19

Introduction:

During COVID-19 pandemics family medicine practices (FMPs) needed to adapt their workflow organization and care processes in order to protect staff and other patients from infectious disease, while striving to meet patients’ needs and deliver safe and quality care. This study aimed to describe organization of care and asses possible differences in urban and rural FMPs in Croatia during COVID-19 pandemics in terms of safe and effective care.

Method:

Data was collected from a convenient sample of 1270 FMPs in Croatia from March to June 2021 as a part of the international cross-sectional PRICOV-19 study. The items related to adaptations in the practice organization, triage of patients and delays in care were analyzed. Differences between urban and rural FMPs were assessed using chi-square test.

Results:

A total of 148 questionnaires (response rate 11.7%) was included in the analysis. FMPs used appointment systems and performed triage before patients entered the practice (98.4%), using protocols (97.3%) and calling patients who made online appointments to check infection risk (89.1%). FMPs actively reached out to patients with chronic conditions (66.1%), with practices from rural areas reporting to reach out to patients who might postpone care more actively (p=0.028). A delayed care process for non-COVID-19 patients was reported by 9.6% to 28.2% of the responding FMPs.

Conclusions:

In response to COVID-19 pandemics, FMPs in Croatia implemented changes to health care processes focused to infection prevention, while aiming to preserve continuing care for chronic patients. Despite these efforts, a notable proportion of FMPs reported delays in non-COVID-19 related care, highlighting the ongoing challenges in maintaining timely healthcare delivery during a pandemic.

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