How Austrian primary care physicians formed their concept of care quality during the first ten months of the COVID-19 pandemic. A repeated cross-sectional survey research

Abstract

Abstract Background. In March 2020, Austria was among the first European countries to declare a national lockdown, responding to SARS-CoV-2 infections with a stringent ringfencing policy for inpatient beds. These interventions altered access to the Austrian healthcare system. This study aims to understand demand- and supply-side factors influencing Austrian Primary Care Physicians’ (PCPs’) assessment of their care quality during the first ten months of the COVID-19 pandemic. Methods. The study deployed a cross-section design based on stratified random sampling, where all Austrian PCPs (split into three disjointed random samples) were invited to participate in an online questionnaire (in May, September and November 2020, respectively). A multinomial logit model analyses the three sets of cross-sectional survey data. The study subjects are all 6,679 Austrian PCP (2020) with a registered practice. The total sample size was 403 (corresponding to a net response rate of 6.3%). Results. The primary outcome was the PCPs’ evaluation of their care quality. Secondary outcomes were “patient behaviour and wellbeing” (five questions), with Cronbach’s alpha of 0.74, and the PCPs’ “pandemic preparedness” (five questions) with a smaller internal consistency (0.69). 47% of the PCPs rated their care quality during the first ten months of the pandemic as worse than before the outbreak of COVID-19. The overall assessment correlates to the pandemic stage, lack of preventive care and mediocre information exchange/cooperation within the medical profession. Towards the end of the first lockdown, PCPs’ care quality perception was exclusively shaped by the availability of SARS-CoV-2 tests at the practice. Conclusions. With improved resource supply towards the end of 2020, demand-side factors like the uptake of medical check-ups and screenings increasingly defined PCPs’ quality perception. Also, respondents described waiting times for elective specialist care as significantly increasing during lockdown periods. However, they did not include them when perceiving their care quality.