Primary care COVID-19 pathways in European countries, preliminary results from a qualitative study

Marina Guisado-Clavero, Raquel Gomez Bravo, Limor Adler, Radost Assenova, Sabine Bayen, Elena Brutskaya-Stempk Ovskaya, Iliana-Carmen Busneag, Asja Ćosić Divjak, Maryher Delphin Peña, Philippe-Richard Domeyer, Sabine Feldmane, Louise Fitzgerald, Ileana Gefaell, Dragan Gjorgjievski, Mila Gómez-Johansson, Miroslav Hanževački, Oksana Ilkov, Shushman Ivanna, Marijana Jandrić-Kočić, Vasilis Trifon Karathanos, Aleksandar Kirkovsk, Snežana Knežević, Büşra Çimen Korkmaz, Milena Kostić, Liga Kozlovska, Bruno Heleno, Katarzyna Nessler, Heidrun Lingner, Gabrielle Lisembard, Murauskienė Liubovė, Bakola Maria, Ana Luisa Neves, Naldy Parodi López, Davorina Petek, Ferdinando Petrazzuoli, Goranka Petricek, Lourdes Ramos Del Río, Natalija Saurek-Aleksandrovska, Alissa Sebbah, Bohumil Seifert, Alice Serafini, Theresa Sentker, Gunta Ticmane, Péter Torzsa, Canan Tuz, Raimonda Ulianskiene, Dorien Vanden Bossche, Maria Van Den Muijsenbergh, Sara Willems, Sara Ares Blanco, María Pilar Astier Peña

Keywords: Primary Health Care, COVID-19, SARS-CoV-2, Clinical Pathways, Health Information System

COVID-19 patients were treated in primary care (PC) in Europe but how the care was delivered in the different countries has not been described.

Research questions:
How was the acute clinical pathway by Europe countries in the diagnosis and follow-up for COVID-19 pandemic in PC?

Descriptive, cross-sectional, retrospective study with qualitative data acquired through a semi-structured questionnaire to know COVID-19 pathway in PC in Europe (31 countries participating). Main variable: PC COVID-19 acute clinical pathway. Secondary variables: COVID-19 diagnosis, testing, hotline, remote assessment. All variables were collected from each country in September 2020.

preliminary results from 12 countries (Byelorussia, Bosnia, Cyprus, Greece, Italy, North-Macedonia, Portugal, Romania, Serbia, Slovenia, Turkey, Ukraine) out of 31. Patients with suspicious COVID-19 accessed in first place to PC with RT-PCR free testing in public health system in all the countries, 10 countries also provided COVID-19 hotlines. Testing was available in PC in 6 countries and in 5 countries PC tested the immobile patients. PC collaborated to the contact tracing along with other institutions in 2 countries. Physical exploration was made in PC in 9 countries. PC asked for complementary tests directly in 7 countries. 4 countries had some restrictions to prescribe COVID-19 treatment in PC. The sick leave was released in PC in all the countries. All the countries recommended isolation during 14 days (Turkey, North Macedonia and Slovenia allowed 10 days in some cases) and only 4 countries requested additional testing after finishing the isolation. 4 countries provided other accommodation if patients could not isolate themselves.

COVID-19 patients were attended in PC in all the countries with free testing. The physical exploration, access to complementary tests, COVID-19 treatment and contact tracing was not available in all the countries in PC.

Points for discussion:
1. What is the usefulness of collecting data about COVID-19 pathway in PC in European countries?