Changes in consultation mode during different phases of the COVID-19 pandemic in Croatian family medicine: a cross-sectional study

Abstract

ObjectivesTo describe the changes in the type, length and reasons for consultations in primary healthcare during the COVID-19 pandemic in Croatia. This study aimed to test a hypothesis regarding the increased workload of general practitioners (GPs) by introducing more virtual consultations (VCs).DesignThe study design was cross-sectional and comprised two phases: retrospective and prospective. The retrospective phase included data from April, May and June of 2019, 2020 and 2021, and the prospective phase included data from 2 weeks in June 2021. Additionally, the number, length and reasons for face-to-face consultations (FTFC), VCs and telephone consultations (TCs) with nurses were collected.Setting and participantsOverall, 6 GPs from different regions in Croatia with 10 125 enlisted patients.Main outcomes measuresThe retrospective phase compared data for consultation types obtained from electronic medical records. The prospective phase collected the number, length and reasons for FTFCs, VCs and TCs with nurses.ResultsFTFCs decreased from 58.1% of the total number of visits in 2019 to 41.2% in 2020, while VC increased from 41.9% in 2019 to 58.8% in 2020. Furthermore, an eightfold increase in email consultations was recorded. The average lengths of an FTFC and TC were 7.13±3.38 and 4.01±2.09 min, respectively; FTFCs were significantly longer than TCs (t=7.038, p<0.0001). There was an increase in the total workload (9.4%) in 2021 compared with 2019.ConclusionCroatian GPs faced changes in work organisation along with increased workload during the pandemic. Despite the shortening of time in FTFCs, the workload has increased due to the increase in VCs. An appropriate legal framework should be implemented for this new form of consultation. Future research is needed to address the impact of these changes on healthcare quality.

The Attitudes and Practices Regarding COVID-19 among General Practitioners from Croatia and Bosnia and Herzegovina: A Cross-Sectional Study

“…The final sample size of this study was rather small, although the response rate was acceptable, which was a consequence of the quite large portion of discarded questionnaires that were incomplete. The majority of those incomplete questionnaires came from Croatian GPs and were probably connected with the enormous workload of Croatian GPs during the COVID-19 pandemic because it is well-known fact that even before the pandemic, Croatian GPs were facing an increased workload [48].…”

Family Physicians’ Perceptions of Primary Health Care Use in Bosnia and Herzegovina during the Covid-19 Pandemic, a Cross-sectional Study

“…During the pandemic, family physicians in Croatia encountered changes in work organisation and an increase in workload. Due to the increase in virtual contacts and telephone consultations, the workload has increased despite the reduction in face-to-face consultation time ( 29 ).…”