Abstract
Introduction With the onset of Coronavirus disease (COVID-19), primary care has swiftly transitioned from face-to-face to virtual care, yet it remains largely unknown how this has impacted the quality and safety of care. We aim to evaluate patient use of virtual primary care models during COVID-19, including change in uptake, perceived impact on the quality and safety of care and willingness of future use. Methodology An online cross-sectional survey was administered to the public across the United Kingdom, Sweden, Italy and Germany. McNemar tests were conducted to test pre- and post-pandemic differences in uptake for each technology. One-way analysis of variance was conducted to examine patient experience ratings and perceived impacts on healthcare quality and safety across demographic characteristics. Results Respondents (n = 6326) reported an increased use of telephone consultations ( + 6.3%, p < .001), patient-initiated services ( + 1.5%, n = 98, p < 0.001), video consultations ( + 1.4%, p < .001), remote triage ( + 1.3, p < 0.001) and secure messaging systems ( + 0.9%, p = .019). Experience rates using virtual care technologies were higher for men (2.4 ± 1.0 vs. 2.3 ± 0.9, p < .001), those with higher literacy (2.8 ± 1.0 vs. 2.3 ± 0.9, p < .001), and participants from Germany (2.5 ± 0.9, p < .001). Healthcare timeliness and efficiency were the dimensions most often reported as being positively impacted by virtual technologies (60.2%, n = 2793 and 55.7%, n = 2,401, respectively), followed by effectiveness (46.5%, n = 1802), safety (45.5%, n = 1822), patient-centredness (45.2%, n = 45.2) and equity (42.9%, n = 1726). Interest in future use was highest for telephone consultations (55.9%), patient-initiated digital services (56.1%), secure messaging systems (43.4%), online triage (35.1%), video consultations (37.0%) and chat consultations (30.1%), although significant variation was observed between countries and patient characteristics. Discussion Future work must examine the drivers and determinants of positive experiences using remote care to co-create a supportive environment that ensures equitable adoption and use. Comparative analysis between countries and health systems offers the opportunity for policymakers to learn from best practices internationally.
Highlights
With the onset of Coronavirus disease (COVID-19), primary care has swiftly transitioned from face-toface to virtual care, yet it remains largely unknown how this has impacted the quality and safety of care
This study aimed to evaluate the impact of the adoption of virtual technologies by patients for primary care access during the COVID-19 pandemic
No significant differences were found in the composition of the female versus male respondents in the UK (51.4% vs. 48.6%), Germany (51.0% vs. 49.0%), Italy (52.4% vs. 47.6%) and Sweden (50.0% vs. 50.0%) (χ2 = 1.376, p = 0.711)
Summary
With the onset of Coronavirus disease (COVID-19), primary care has swiftly transitioned from face-toface to virtual care, yet it remains largely unknown how this has impacted the quality and safety of care. Guidance, primary care practitioners have adapted their models of care to offer over 85% of consultations remotely via phone or video link, where previously 95% of consultations took place face to face.[1] in Italy, the Digital Solidarity initiative launched by the Minister for Technological Innovation and Digitization, offers online public or specialist services in response to the pandemic, including health services such as ‘Video Visita’ (Video Visit), which offers patients free video consultations with family doctors and paediatricians signed up to the service.[2]. Uptake at scale prior to the pandemic was slow and challenging
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