Ten pressure points in primary care during COVID-19: findings from an international narrative review
Abstract Background Strong primary care (PC) services are the foundation of high-performing health care systems and can support effective responses to public health emergencies. Primary care practitioners (PCPs) and PC services played crucial roles in supporting global health system responses to the...
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| Language: | English |
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BMC
2025-01-01
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| Series: | BMC Primary Care |
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| Online Access: | https://doi.org/10.1186/s12875-024-02640-w |
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| author | Sally Hall Dykgraaf Anne Parkinson Michael Wright William C. W. Wong Jane Desborough Lauren Ball Elizabeth Sturgiss Garang M. Dut Katelyn Barnes Danielle Butler Steph Davis Kirsty Douglas Candan Kendir Danielle Martin Robert Marten Katherine Rouleau Shannon Barkley Lucas de Toca Michael Kidd |
| author_facet | Sally Hall Dykgraaf Anne Parkinson Michael Wright William C. W. Wong Jane Desborough Lauren Ball Elizabeth Sturgiss Garang M. Dut Katelyn Barnes Danielle Butler Steph Davis Kirsty Douglas Candan Kendir Danielle Martin Robert Marten Katherine Rouleau Shannon Barkley Lucas de Toca Michael Kidd |
| author_sort | Sally Hall Dykgraaf |
| collection | DOAJ |
| description | Abstract Background Strong primary care (PC) services are the foundation of high-performing health care systems and can support effective responses to public health emergencies. Primary care practitioners (PCPs) and PC services played crucial roles in supporting global health system responses to the COVID-19 pandemic. However, these contributions have come at a cost, impacting on PC services and affecting patient care. This secondary analysis of data from an integrative systematic review across international PC settings aimed to identify and describe burdens and challenges experienced by PCPs and PC services in the context of their contributions to COVID-19 pandemic responses. Methods We conducted an integrative systematic review and narrative analysis, searching PubMed/Medline, Scopus, Proquest Central and Cochrane Database of Systematic Reviews, plus reference lists of key publications. Included studies were published in peer-reviewed English or Chinese language journals, and described collective responses to COVID-19 undertaken in PC settings or by PCPs. Narrative data regarding impacts on PC services and challenges experienced by PCPs were extracted and analysed using inductive coding and thematic analysis. Results From 1745 screened papers 108, representing 90 countries, were included. Seventy-eight contained data on negative impacts, challenges or issues encountered in PC. Ten ‘pressure points’ affecting PC during COVID-19 were identified, clustered in four themes: demand to adopt new ways of working; pressure to respond to fluctuating community needs; strain on PC resources and systems; and ambiguity in interactions with the broader health and social care system. Conclusions PCPs and PC services made critical functional contributions to health system responsiveness during the COVID-19 pandemic. However, both practitioners and PC settings were individually and collectively impacted during this period as a result of changing demands in the PC environment and the operational burden of additional requirements imposed on the sector, offering lessons for future pandemics. This study articulates ten empirically derived ‘pressure points’ that provide an initial understanding of burdens and demands imposed on the international primary care sector during the COVID-19 pandemic. The impact of these contributions should inform future pandemic planning, guided by involvement of PCPs in public health preparedness and policy design. |
| format | Article |
| id | doaj-art-1412e3ba9dc14c01b6392bc50ead5a99 |
| institution | Kabale University |
| issn | 2731-4553 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Primary Care |
| spelling | doaj-art-1412e3ba9dc14c01b6392bc50ead5a992025-01-26T12:45:52ZengBMCBMC Primary Care2731-45532025-01-0126112510.1186/s12875-024-02640-wTen pressure points in primary care during COVID-19: findings from an international narrative reviewSally Hall Dykgraaf0Anne Parkinson1Michael Wright2William C. W. Wong3Jane Desborough4Lauren Ball5Elizabeth Sturgiss6Garang M. Dut7Katelyn Barnes8Danielle Butler9Steph Davis10Kirsty Douglas11Candan Kendir12Danielle Martin13Robert Marten14Katherine Rouleau15Shannon Barkley16Lucas de Toca17Michael Kidd18School of Medicine & Psychology, College of Health & Medicine, Australian National UniversityNational Centre for Epidemiology & Population Health, College of Health & Medicine, Australian National UniversityCentre for Health Economics Research and Evaluation, University of TechnologyDepartment of Family Medicine and Primary Care Ap Lei Chau Clinic, University of Hong KongNational Centre for Epidemiology & Population Health, College of Health & Medicine, Australian National UniversityCentre for Community Health and Wellbeing, The University of QueenslandSchool of Primary and Allied Health Care, Monash University (Peninsula Campus)College of Health & Medicine, Australian National UniversitySchool of Medicine & Psychology, College of Health & Medicine, Australian National UniversityNational Centre for Epidemiology & Population Health, College of Health & Medicine, Australian National UniversityNational Centre for Epidemiology & Population Health, College of Health & Medicine, Australian National UniversitySchool of Medicine & Psychology, College of Health & Medicine, Australian National UniversityOrganisation for Economic Co-operation and DevelopmentDepartment of Family and Community Medicine, University of TorontoAlliance for Health Policy and Systems Research, World Health OrganizationDepartment of Family and Community Medicine, University of TorontoSpecial Programme on Primary Health Care, World Health OrganizationAustralian Government Department of Health and Aged CareCollege of Health & Medicine, Australian National UniversityAbstract Background Strong primary care (PC) services are the foundation of high-performing health care systems and can support effective responses to public health emergencies. Primary care practitioners (PCPs) and PC services played crucial roles in supporting global health system responses to the COVID-19 pandemic. However, these contributions have come at a cost, impacting on PC services and affecting patient care. This secondary analysis of data from an integrative systematic review across international PC settings aimed to identify and describe burdens and challenges experienced by PCPs and PC services in the context of their contributions to COVID-19 pandemic responses. Methods We conducted an integrative systematic review and narrative analysis, searching PubMed/Medline, Scopus, Proquest Central and Cochrane Database of Systematic Reviews, plus reference lists of key publications. Included studies were published in peer-reviewed English or Chinese language journals, and described collective responses to COVID-19 undertaken in PC settings or by PCPs. Narrative data regarding impacts on PC services and challenges experienced by PCPs were extracted and analysed using inductive coding and thematic analysis. Results From 1745 screened papers 108, representing 90 countries, were included. Seventy-eight contained data on negative impacts, challenges or issues encountered in PC. Ten ‘pressure points’ affecting PC during COVID-19 were identified, clustered in four themes: demand to adopt new ways of working; pressure to respond to fluctuating community needs; strain on PC resources and systems; and ambiguity in interactions with the broader health and social care system. Conclusions PCPs and PC services made critical functional contributions to health system responsiveness during the COVID-19 pandemic. However, both practitioners and PC settings were individually and collectively impacted during this period as a result of changing demands in the PC environment and the operational burden of additional requirements imposed on the sector, offering lessons for future pandemics. This study articulates ten empirically derived ‘pressure points’ that provide an initial understanding of burdens and demands imposed on the international primary care sector during the COVID-19 pandemic. The impact of these contributions should inform future pandemic planning, guided by involvement of PCPs in public health preparedness and policy design.https://doi.org/10.1186/s12875-024-02640-wPrimary carePrimary health careFamily practiceGeneral practiceCOVID-19 pandemicDisaster planning |
| spellingShingle | Sally Hall Dykgraaf Anne Parkinson Michael Wright William C. W. Wong Jane Desborough Lauren Ball Elizabeth Sturgiss Garang M. Dut Katelyn Barnes Danielle Butler Steph Davis Kirsty Douglas Candan Kendir Danielle Martin Robert Marten Katherine Rouleau Shannon Barkley Lucas de Toca Michael Kidd Ten pressure points in primary care during COVID-19: findings from an international narrative review BMC Primary Care Primary care Primary health care Family practice General practice COVID-19 pandemic Disaster planning |
| title | Ten pressure points in primary care during COVID-19: findings from an international narrative review |
| title_full | Ten pressure points in primary care during COVID-19: findings from an international narrative review |
| title_fullStr | Ten pressure points in primary care during COVID-19: findings from an international narrative review |
| title_full_unstemmed | Ten pressure points in primary care during COVID-19: findings from an international narrative review |
| title_short | Ten pressure points in primary care during COVID-19: findings from an international narrative review |
| title_sort | ten pressure points in primary care during covid 19 findings from an international narrative review |
| topic | Primary care Primary health care Family practice General practice COVID-19 pandemic Disaster planning |
| url | https://doi.org/10.1186/s12875-024-02640-w |
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