Response of General Practitioners to Infectious Disease Public Health Crises: An Integrative Systematic Review of the Literature

Kunin, Marina; Engelhard, Dan; Piterman, Leon; Thomas, Samantha

doi:10.1017/dmp.2013.82

Cited by 40 publications

(37 citation statements)

References 26 publications

(91 reference statements)

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“…Evaluation of healthcare system responses to earlier infectious pandemics shows various approaches and different levels of involvement of primary care in different countries, but generally a non-optimal preparedness. [6][7][8] Difficulties in supply and use of PPE, healthcare decisions such as prioritisation of high-risk patients, support from authorities, lack of knowledge and training and the emotional burden, are factors that compromise an effective response to a pandemic. In past years, various and divergent preparedness plans have been developed in different countries.…”

Section: Open Accessmentioning

confidence: 99%

Impact of the COVID-19 pandemic on the core functions of primary care: will the cure be worse than the disease? A qualitative interview study in Flemish GPs

et al. 2020

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ObjectivesThe current COVID-19 pandemic, as well as the measures taken to control it, have a profound impact on healthcare. This study was set up to gain insights into the consequences of the COVID-19 outbreak on the core competencies of general practice, as they are experienced by general practitioners (GPs) on the frontline.Design, setting, participantsWe performed a descriptive study using semistructured interviews with 132 GPs in Flanders, using a topic list based on the WONCA definition of core competencies in general practice. Data were analysed qualitatively using framework analysis.ResultsChanges in practice management and in consultation strategies were quickly adopted. There was a major switch towards telephone triage and consults, for covid-related as well as for non-covid related problems. Patient-centred care is still a major objective. Clinical decision-making is largely focused on respiratory assessment and triage, and GPs feel that acute care is compromised, both by their own changed focus and by the fact that patients consult less frequently for non-covid problems. Chronic care is mostly postponed, and this will have consequences that will extend and become visible after the corona crisis. Through the holistic eyes of primary care, the current outbreak—as well as the measures taken to control it—will have a profound impact on psychological and socioeconomic well-being. This impact is already visible in vulnerable people and will continue to become clear in the medium and long terms. GPs think that they are at high risk of getting infected. Dropping out and being unable to contribute their part or becoming virus transmitters are reported to be greater concerns than getting ill themselves.ConclusionsThe current times have a profound impact on the core competences of primary care. Although the vast increase in patients soliciting medical help and the necessary separate covid and non-covid flows have been dealt with, GPs are worried about the continuity of regular care and the consequences of the anticovid measures. These may become a threat for the general health of the population and for the provision of primary healthcare in the near and distant future.

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Section: Open Accessmentioning

confidence: 99%

Impact of the COVID-19 pandemic on the core functions of primary care: will the cure be worse than the disease? A qualitative interview study in Flemish GPs

et al. 2020

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“…It is important for health care systems to recognize the value of a strong coordinated response to this crisis from a primary health perspective, 2 with best practices that are transferable across nations. This is essential given that the early presentation of COVID-19 infection is nonspecific, with most patients presenting to primary health care clinics with mild upper respiratory tract symptoms.…”

Section: Introductionmentioning

confidence: 99%

COVID-19: Notes From the Front Line, Singapore’s Primary Health Care Perspective

Lim

Wong

2020

Ann Fam Med

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Coronavirus disease 2019 (COVID-19) is a rapidly progressing global pandemic against which nations are struggling for containment. Singapore is known to have promptly instituted aggressive public health and containment measures.A key pillar sustaining this is the response of its primary health care network. It is important for health care systems worldwide to recognize the value of a strong coordinated response to this crisis from a primary health perspective. There are best practices for early isolation and containment of suspect cases while protecting health care workers and limiting cross infections that are transferable across nations. We describe our framework for how our primary care clinics respond to this pandemic in the hope others may find solutions to their unique needs. Moving forward, there is a pressing need for more studies to enhance our understanding of the response of primary care during these public health crises. Ann Fam Med 2020;18:259-261. https://doi.org/10.1370/afm.2539.

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“…Previous studies have shown that GPs' training skills can effectively increase the value of community health services. For example, it helps for more active participation in cancer screen, the management improvement of systemic diseases, and better solution to the epidemic public health crisis [2,3,4,5]. In China, because the reputation of community health care institutions nowadays is still far lower than the large general hospitals, the patient's trust in the level of community health service technology is relatively low, and the amount of medical visits is not high, which leads to the serious lack of willingness of GPs to invest in medical efforts [6].…”

Section: Introductionmentioning

confidence: 99%

Research on Performance Incentive Mechanism of General Practitioners under the Consideration of Reputation Effect

Peng

2019

Preprint

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BackgroundIn China, General practitioners (GPs) have a weaker reputation than specialists, which leads to their low professional identity. Therefore, GPs’ reputation is a bottleneck restricting their participation in skills training and the realization of the service value of community health centre. Because the GPs’ reputation accumulation can only rely on the improvement of personal skills ,it is necessary to combine the improvement of medical skills to the future economic interests of the GPs, and establishing an effective dynamic reputation incentive mechanism. The purpose of this paper is to explore the dynamic reputation incentive mechanism for GPs, and analyze its performance. MethodsIn this paper, a dynamic incentive model of the GPs in two stages under the effect of explicit and implicit reputation is established and solved by using game theory and agent-principal theory. ResultsThe explicit reputation affects GPs’ determined incomes mainly through fixed awards, and the medical effort input in Stage 1 decreases with the performance award in Stage 2 under the reputation mechanism; the increase of the implicit reputation coefficient can improve the medical performance output, the performance award level and the total value of medical service value, and the explicit reputation correction factor plays the opposite role; when the implicit reputation coefficient and explicit reputation correct factor meet certain conditions, the implementation of reputation incentive can lead to the Pareto effect of GPs’ medical effort and performance awards.Conclusion(1) explicit reputation mainly affects GPs’ deterministic income in Stage 2 by changing the fixed benefits; (2) the medical efforts in the Stage 1 depend on the unit performance incentive coefficient in both stages, and show a certain ratchet effect; (3) implicit reputation can help to improve the level of medical efforts at each stage; (4) the reputation uncertainty will reduce the level of medical efforts and unit performance incentive at each stage; (5) when the explicit reputation correction coefficient is lower than a certain threshold, the implement of reputation incentive can realize the Pareto effect of medical efforts.

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Response of General Practitioners to Infectious Disease Public Health Crises: An Integrative Systematic Review of the Literature

Abstract: GPs' response to public health crises in different countries presents potential for improving pandemic preparedness.

Cited by 40 publications

References 26 publications

Impact of the COVID-19 pandemic on the core functions of primary care: will the cure be worse than the disease? A qualitative interview study in Flemish GPs

Impact of the COVID-19 pandemic on the core functions of primary care: will the cure be worse than the disease? A qualitative interview study in Flemish GPs

COVID-19: Notes From the Front Line, Singapore’s Primary Health Care Perspective

Research on Performance Incentive Mechanism of General Practitioners under the Consideration of Reputation Effect

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