General practitioner care in nursing homes during the first wave of the COVID-19 pandemic in Germany: A retrospective survey among nursing home managers

Abstract

Background Though evidence on the detrimental impact of the COVID-19 pandemic in nursing homes is vast, research focusing on general practitioners’ (GP) care during the pandemic in nursing homes is still scarce. Methods A retrospective online survey among 1,010 nursing home managers in Germany was conducted during the first wave of the COVID-19 pandemic between November 2020 and February 2021. Associations between perceived deficits in GP care (routine and acute visits) and both general and COVID-19-related characteristics of nursing homes were analysed using multiple logistic regression analyses. Results The majority of nursing home managers reported no deficits in GP care (routine visits, 84.3%; acute visits, 92.9%). Logistic regression analyses revealed that deficits in GP care (routine visits) were associated with visiting restrictions for GPs (p < .001) and nursing home size. Small nursing homes (1–50 residents) were more likely to report deficits in GP care (routine visits) compared to medium (51–100 residents; p = .05) and large nursing homes (> 100 residents; p < .05). Further, deficits in GP care (acute visits) were associated with dementia as a focus of care (p < .05) and the burden of insufficient testing for SARS-CoV-2 among residents (p < .05). Moreover, visiting restrictions for GPs were associated with dementia as the focus of care (p < .05) and the COVID-19 incidence at the state (Bundesstaat) level (p < .05). Finally, COVID-19 cases in nursing homes were associated with size of nursing homes (p < .01; p < .001), COVID-19-incidence on the state level (p < .05; p < .01) and the burden of insufficient testing capacities for SARS-CoV-2 among residents (p < .01). Conclusion We found structural factors associated with GP care deficits during the pandemic. New concepts for GP care should be implemented in pandemic preparedness plans to ensure high quality, consistent, and reliable GP care as well as effective infection prevention measures in nursing homes.

The COVID-19 Pandemic and Responses in Nursing Homes: A Cross-Sectional Study in Four European Countries

“…This raises the question of the capacity of the NHs to take care of COVID-19 patients, which could differ between the countries. Indeed, in Germany, it has been shown that the majority of NH managers reported no deficits in general practitioners' [16].…”