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Exploring the accessibility of primary health care data in Europe's COVID-19 response: developing key indicators for managing future pandemics (Eurodata study)

BMC Primary Care volume 25, Article number: 221 (2024) Cite this article

Abstract

Background

Primary Health Care (PHC) plays a crucial role in managing the COVID-19 pandemic, with only 8% of cases requiring hospitalization. However, PHC COVID-19 data often goes unnoticed on European government dashboards and in media discussions. This project aims to examine official information on PHC patient care during the COVID-19 pandemic in Europe, with specific objectives: (1) Describe PHC’s clinical pathways for acute COVID-19 cases, including long-term care facilities, (2) Describe PHC COVID-19 pandemic indicators, (3) Develop COVID-19 PHC activity indicators, (4) Explain PHC’s role in vaccination strategies, and (5) Create a PHC contingency plan for future pandemics.

Methods

A mixed-method study will employ two online questionnaires to gather retrospective PHC data on COVID-19 management and PHC involvement in vaccination strategies. Validation will occur through focus group discussions with medical and public health (PH) experts. A two-wave Delphi survey will establish a European PHC indicators dashboard for future pandemics. Additionally, a coordinated health system action plan involving PHC, secondary care, and PH will be devised to address future pandemic scenarios. Analysis: Quantitative data will be analysed using STATA v16.0 for descriptive and multivariate analyses. Qualitative data will be collected through peer-reviewed questionnaires and content analysis of focus group discussions. A Delphi survey and multiple focus groups will be employed to achieve consensus on PHC indicators and a common European health system response plan for future pandemics. The Eurodata research group involving researchers from 28 European countries support the development.

Discussion

While PHC manages most COVID-19 acute cases, data remains limited in many European countries. This study collects data from numerous countries, offering a comprehensive perspective on PHC’s role during the pandemic in Europe. It pioneers the development of a PHC dashboard and health system plan for pandemics in Europe. These results may prove invaluable in future pandemics. However, data may have biases due to key informants’ involvement and may not fully represent all European GP practices. PHC has a significant role in the management of the COVID-19 pandemic, as most of the cases are mild or moderate and only 8% needed hospitalization. However, PHC COVID-19 activity data is invisible on governments’ daily dashboards in Europe, often overlooked in media and public debates.

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Introduction

The COVID-19 pandemic, with over 661 million confirmed cases as of January 2023, predominantly impacts mild and moderate cases handled within primary health care (PHC) settings. Only 8% of reported cases necessitated hospitalization, a tendency diminishing as vaccination efforts progress with the active participation of PHC professionals [1]. Despite the pivotal role played by PHC, it remains overlooked on government dashboards and in media discussions.

Current COVID-19 pandemic information

Public health (PH) agencies worldwide furnish data on COVID-19, focusing on reported cases, testing, hospital occupancy, and vaccination. However, none spotlight the pandemic’s impact on PHC, underscoring a critical information gap [2,3,4]. The pandemic has reshaped healthcare delivery, reducing face-to-face appointments while increasing remote consultations, particularly for mild and moderate cases [5,6,7]. New clinical pathways for COVID-19 cases were established, with RT-PCR testing often conducted in PHC [8]. Limited availability of PHC open data globally, mainly from countries with public provision health systems and population-based PHC information systems [9,10,11], or public facilities within predominantly private provision systems [12], underscores the necessity for standardized reporting, especially in private healthcare systems [13].

Interprofessional collaboration during the COVID-19 pandemic to guarantee comprehensive care

An effective pandemic response requires collaboration among PHC. The integration of health information is crucial, emphasizing the necessity to include PHC in pandemic dashboards and provide comprehensive training for PHC professionals. It is well-acknowledged that both PHC and PH are essential services, with a shared goal of promoting the health of the global community. However, their roles are complementary. For instance, PHC performs certain PH functions such as screening, immunization, and interventions to support healthy lifestyles, while PH enhances the effectiveness of PHC by addressing issues like health and disease surveillance, planning, and evaluation [14].

Historically, pandemics lacked PHC data, with no registered data from PHC for previous events like the SARS, MERS, H1N1 influenza, Zika, and Ebola pandemics [15]. However, information from PHC has been provided for other PH issues, such as influenza [16, 17], and various health conditions [18, 19]. Desborough et al. [15] proposed recommendations for enhancing the COVID-19 pandemic response from PHC. These suggestions included improving collaboration, communication, and integration between PH and PHC, defining the role of PHC during pandemics to offer consistent, coordinated, and reliable information from a common, trusted PHC source, involving PHC experts in national health crisis commissions, and ensuring the ability to evaluate intervention effectiveness. It is evident that training PHC professionals in their PH role could contribute to enhancing this interoperability.

Factors affecting the lack of PHC open data during the COVID-19 pandemic

Nevertheless, collecting PHC data presents certain challenges, such as code variability, misclassification [20], or the use of free text to record information related to essential clinical data for epidemiological surveillance [21, 22]. Moreover, the interoperability of electronic health records (EHR) among different health system levels (PH, PHC and seconday care) is exceptionally uncommon among providers, regions within a country, and internationally [23]. A contributing factor to the absence of publicly available European PHC data may be linked to the lack of interoperability between PHC information systems and PH administration information systems within European countries [24]. It is noteworthy that there is no agreed-upon minimum set of patient health data for national and European PHC, and consequently, a collection of pertinent epidemiological elements that could be centralized [25]. This stands in contrast to the approach taken with the COVID-19 vaccination certificate across Europe (Green Card). Table 1 outlines various reasons for the absence of open PHC data availability, addressing and explaining each contributing factor.

Table 1 Identification of areas for improvement in information technologies systems in primary health care during the COVID-19 pandemic
Full size table

A centralized data repository containing pertinent clinical and epidemiological information about COVID-19 management could have facilitated the integration of PHC COVID-19 activity indicators with data from other departments like microbiology labs and accident and emergency departments. The mentioned set of health information from patients’ EHR is relevant to have timely insights into the evolution of the pandemic. Moreover, it would not only enhance information for integrated care but also contribute to scientific research and healthcare planning, as illustrated in Fig. 1. Furthermore, there is currently a lack of cross border interoperability and secure access to EHR. The European Commission has already issued recommendations on this topic and is currently working on a legislative proposal on a European Health Data Space [26]. This initiative aims to facilitate data access and sharing among countries, addressing challenges such as interoperability of health information systems.

In many countries with a comprehensive PHC network, integrated health information systems exist, which could enable the incorporation of PHC data into the national COVID-19 dashboard [27]. Including COVID-19 PHC data would contribute to establishing an expanded pandemic dashboard in leading institutions and agencies (WHO, CDC, ECDC, etc.). New initiatives, such as the National PHC Data Collection of the Australian government, are building new health information systems that involve all stakeholders, including PHC [28]. However, it is surprising that recent legislation like the European Union’s (EU) recent proposal for the ECDC regulation, fails to mention standardized PHC data collection [29].

Fig. 1
figure 1

The role of primary health care in Europe during pandemics

PHC: Primary health care

Full size image

Proactive planning for future health challenges: strengthening PHC systems for crisis response

During the COVID-19 pandemic, numerous digital health tools emerged, becoming an immediate necessity, and their usage significantly increased [30]. COVID-19 apps were developed in most of European countries without integration with PHC information systems.

Consequently, the full potential of these apps was not appropriately harnessed due to a lack of healthcare continuity.

This transformative approach necessitates significant funding for national and international PHC health information systems, particularly in Europe, to effectively address future health challenges. WHO Europe is urging all countries to allocate an additional 1% of the gross domestic product to PHC after the pandemic [31]. An in-depth policy analysis and interviews with family physicians across Europe could contribute to the establishment of a reliable European health information system, similar to successful initiatives in other countries [32].

The EU4Health program and other initiatives [33, 34] should allocate targeted funds to strengthen PHC, ensuring a comprehensive perspective on healthcare system performance. Some European initiative refers to research data base as the European Health Information Portal [35]. It contains catalogues for data sources, national and European projects, research infrastructures, capacity building activities, and COVID-19 related resources. This portal aids researchers in finding and accessing population health information promptly. This project originated from the Joint Action on Health Information InfAct (Information for Action! ) was funded by the European Commission, involving 40 partners in 28 EU and associated countries [36]. Presently, policymakers and healthcare system managers continue to primarily base their decisions on data from hospitals, mortality, and vaccination records.

The aftermath of the COVID-19 pandemic offers a valuable opportunity to enhance the utilization of digital health tools, with a particular emphasis on integrating PHC data. This effort should also prioritize making knowledge accessible, including within PHC, which serves as the initial point of contact for population healthcare [37]. This includes research on the development of PHC dashboards based on EHR [38]. It is now more urgent than ever to provide a comprehensive view of healthcare system performance in the context of the COVID-19 pandemic.

The assessment of the ongoing pandemic presents a crucial opportunity to elevate the use of digital health tools based on PHC data, addressing new health challenges efficiently and on a population basis. This approach will enhance the interoperability of EHR with PH and secondary care, ultimately leading to the establishment of national and European open population-based PHC data.

Methods

The study aims to gather information on PHC, specifically focusing on medical and social care, the impact of COVID-19, monitoring, prevention, and response plans for future pandemics within the health system, as illustrated in Fig. 1. To operationalize these objectives, we have implemented five distinct research projects (Fig. 1):

  • Project 1: Description of PHC clinical pathways regarding COVID-19 acute cases in European countries and the role of PHC in long-term care facilities (LTCF) COVID-19 clinical pathways in two different pandemic momentums: first wave and after vaccination roll out.

  • Project 2: Description of current COVID-19 pandemic public PHC indicators available in Europe.

  • Project 3: Elaboration of a PHC indicators dashboard regarding COVID-19 pandemic in Europe.

  • Project 4: Description of PHC role in COVID-19 vaccination strategy roll out in European countries.

  • Project 5: To create a comprehensive health system plan to efficiently address a pandemic scenario in PHC in Europe.

Projects’ design

The following information is accordingly with STROBE checklist [39]. A summary of the design of all the projects can be found in Table 2.

Table 2 Summary of the methodology of the projects
Full size table

Design Project 1, 2 and 4

A mixed-methods descriptive study will be carried out, through two online self-administrated ad hoc questionnaire. The questionnaires will be built on information from official sources and consensus will be achieved among all key informants. The first to collect retrospective data on the management of COVID-19 cases, COVID-19 indicators, and COVID-19 vaccination in PHC (Annex 2). Then a flow diagram of acute COVID-19 cases, PHC highlighting strengths and weaknesses will be set as of September 2020 and April 2021, to compare pre and post vaccination clinical pathways. The LTCF healthcare will also be included. The second questionnaire will be prepared to collect detailed information on the role of PHC in national vaccination strategies in Europe.

Participants

Structure of the research consortium

The research consortium is organized with a core team consisting of four specialists in family and community medicine, including one with expertise in PH. These professionals are affiliated with the Spanish Society for Family and Community Medicine (semFYC) [40] and are primarily based in Spain. The core team serves as the central coordinating body for a broader European research initiative.

Within the European research team, the role of country lead researchers is pivotal as national key informants. These lead researchers, who are healthcare professionals representing various European countries, are often affiliated with the World Organization of Family Doctors in Europe (WONCA Europe) [41]. WONCA Europe, boasting a membership of 47 organizations and a network of over 90,000 family doctors across Europe, includes semFYC as its Spanish affiliate (see Annex 1). Both WONCA Europe and semFYC actively support professional development, research, education, and quality enhancement in general practice and family medicine through various networks and specialized interest groups.

A significant number of the country’s lead researchers are members of the European General Practice Research Network (EGPRN). EGPRN, a collaborative working group comprising professionals from PHC and various disciplines, is dedicated to advancing medical research in this field [39,40,41,42]. Serving as a dynamic platform, EGPRN facilitates collaboration among researchers from diverse European countries, fostering joint research efforts in PHC.

Study participants

The participants are key informants from each country, both from the field of PHC and PH for all the studies. For Projects 1, 2 and 4, the participants will be part of the group of collaborators mentioned in Annex 1. For the Projects 3 and 5, the professionals will be recruited by the national collaborators and the core group.

Data collection projects 1, 2 and 4

Variables and analysis (Projects 1 and 2)

Before commencing the study, national collaborators will receive invitations to attend informative webinars conducted by the research core team. Additionally, a comprehensive project overview will be communicated to them via email. Individuals expressing willingness to participate will be designated as national key informants. To formalize their participation, all key informants will sign an informed consent form. Subsequently, they will be emailed the two questionnaires for completion (see Annex 2, 3, 4).To ensure a timely response, two reminders will be sent, and once completed, the questionnaires will be closed. All information gathered through the questionnaires will be meticulously managed using a database for subsequent analysis.

A descriptive analysis of the categorical variables will be performed. Data will be displayed with the absolute number observed and the frequency (percentage). In the case of quantitative variables, these will be presented in means and standard deviations, or median and interquartile range, depending on their type of distribution. The differences among sex, age group and occupation will be tested by use of T-Student test for independent data or an ANOVA test.

Design projects 3 and 5

To respond to the research objectives, Projects 3 and 5 will be structured as follows.

  1. (i)

    Focus groups composed by family medicine and PH specialists from different European countries to address the possible PHC indicators and the key areas to perform a PHC contingency plan for pandemics in Europe. Participants were recruited through professional networks linked to WONCA EUROPE and academic networks.

  2. (ii)

    Development of a two-round Delphi study for the development of PHC activity indicators for the COVID-19 pandemic (Common PHC Pandemic Dashboard).

  3. (iii)

    Elaboration by consensus of a coordinated response health system plan focused on PHC and PH to face future pandemic scenarios (contingency plan).

Data collection projects 3 and 5

The interviews and meetings will be recorded for the subsequent acquisition of the information that emerged in the focus groups. All the information will be collected in English. Data will be collected in the first 18 months of the pandemic since March 2020. Vaccination data will be collected during the first year of the roll up of the vaccination. A content analysis will be performed to get consensus on crucial items.

Variables and analysis projects 3 and 5

  • Sociodemographic variables: gender (man, woman, other), age range (18–45, 46–65, > 66 years), occupation (Family Doctor, PH, other medical specialist), health field (public/private),

  • Countries of the EU and origin of the information obtained: Austria, Belgium, Bulgaria, Croatia, Cyprus, the Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, the Netherlands, Poland, Portugal, Romania, Spain, Slovakia, Slovenia, Sweden.

  • Other European countries: categorical nominal (Iceland, Norway).

  • Detailed description PHC activity indicators during COVID-19 Pandemic.

Qualitative methods

The focus groups and Delphi survey are revised by SRQR [43] checklist.

Focus groups

Three discussion focus groups with the key informants will hold with semi-structured questions in relation to the main constructs related to the collection of PHC data in the pandemic. Proposals for improvement that key informants deem appropriate and viable will be discussed. An interview guide will be provided to discuss the findings from previous works.

Two researchers will carry out a content analysis of the answers and will build a hierarchy of core information.

Delphi Study

Subsequently, based on the information collected from the survey and focus groups, researchers will design a Delphi study. Delphi will consist of a proposed list of indicators for monitoring a pandemic in PHC. The indicators will be validated through two sequential questionnaires arriving at the consensual selection of a set of indicators that will conform a dashboard. The details of the Delphi study can be found in Annex 3. The selection of indicators will be made by quartiles. Those under first quartile will be dropped out, those above the third quartile will be included, and between first and third quartile will be sent to second round [44].

  • Stratification of scorecard results: A simulation of different thresholds of the indicators and the possible decisions to reinforce the care and resources at the PHC level will be carried out depending on the evolution of the pandemic.

  • Statistical analysis Projects 3 and 5: A descriptive analysis of the categorical variables will be carried out, being shown with the absolute number observed and the frequency (percentage). In the case of quantitative variables, these will be expressed with the mean and standard deviation, or median and interquartile range, depending on their distribution. In the first round, participants will be asked to rate the relevance of the indicators using a 5-point Likert scale. Consensus is defined when ≥ 80% of the participants rated a statement as ‘agreed’ or ‘strongly agreed’. Those indicators which have less than 25% of acceptance were eliminated before advancing to the second round. The final indicators will be those which reach an agreement over 80%.

The data for the five projects are stored on the servers of the Madrid Health System, where the principal team members are based. The Delphi Study is carried out using the platform provided by the University Miguel Hernandez de Elche in Spain, where one of the team’s researchers is stationed. For data processing and statistical analysis, we employ STATA software, version 16.

Discussion

The projects face potential limitations, primarily stemming from the scarcity of open available PHC data in each country. Furthermore, the representation of each country is reliant on volunteers from PHC organizations that belong to WONCA Europe, and EGPRN, which could introduce selection bias. Nevertheless, the use of publicly available data in certain projects (1, 2 and 4 ) and oversight by experienced professionals, previously involved, in others aims (3 and 5) to ensure a more uniform understanding and analysis.

Addressing the challenge of scarce PHC data publicly available, our approach includes surveying official websites for initial data gathering and directly requesting data from EU and OECD health departments when necessary. This effort is underscored by the goal of thoroughly evaluating the specified variables in our protocol.

To counter the issue of non-representative countries, we will proactively engage with their health departments for data acquisition. Our contingency plan for limited cooperation involves extensive dissemination of the project and volunteer recruitment via scientific societies and their networks (e.g., EGPRN, WONCA Europe, semFYC, etc.).

The outcomes of this study will be disseminated through diverse channels, including presentation at conferences and scientific gatherings, publication in high-impact journals, and delivery to policymakers and healthcare system administrators. We also plan to share our findings with the public and traditional media to increase awareness of the crucial role of PHC in the healthcare system. As we evaluate the current pandemic through our five projects, we see a significant opportunity to explore the efficient use of digital health tools based on PHC data, addressing future health challenges at a population level. The results may provide insights to enhance the interoperability of EHR with PHC and secondary care across the European Region, ultimately contributing to the development of a national and European open population-based PHC database.

Availability of data and materials

All data generated or analysed during this study can be shared upon request. All the original data can be checked directly through the Supplement files. All methods were carried out in accordance with relevant guidelines and regulations. Further inquiries can be directed to the corresponding author.

Abbreviations

CDC:

Centre for Disease Control of USA

ECDC:

European Centre for Disease Prevention and Control

EGPRN:

European General Practice Research Network

GP:

General Practitioner or Family Doctor

NHS UK:

National Health Services, United Kingdom

OECD:

Organisation for Economic Co-operation and Development

PH:

Public Health

PHC:

Primary Health Care

RT-PCR:

Real-Time - Polymerasa Chain Reaction

semFYC:

Sociedad Española de Medicina Familiar y Comunitaria

WHO:

World Health Organization

WONCA:

World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians

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Acknowledgements

We would like to thank the health professionals who contributed to treat so many COVID-19 patients during the pandemic.

Endorsement

semFYC, EGPRN, WONCA Europe, WONCA World support the need of publicly provided by countries consistent, coordinated and reliable information regarding PHC activity during COVID-19 pandemic.

Legal considerations

The participants of Project 1 will be considered as collaborators of the project. For doing so, they must sign a collaboration agreement (Annex 4) that they can terminate at any time during the project. In addition, the completion of the attached ad hoc questionnaire will reaffirm the voluntary nature of transferring your data for its subsequent exploitation and disclosure.

Participants of Project 1 will be invited to take part in Project 2 and 4. If they agree, they would have already signed the collaboration agreement. For new participants, another participation document will be sent to be sign responding to the specific objectives of this study (Annex 5). The database of the two studies will be managed by the Principal Investigators of the project.

During the realization of this project, the ethical principles contained in the Helsinki Declaration of 2013 will be complied with, as well as with the national legislation contained in Organic Law 15/1999 on Data Protection and Royal Decree 1720/2007. Following the declaration of human rights, an adequate practice and protection of the data obtained will be maintained. The protocol has been approved by the Ethics and Research Committee with medicines of the Hospital Universitario de la Paz (HULP: PI-5030). Informed consent to participate will be obtained from all the participants.

Funding

This study has been granted by the EGPRN to cover the publication fees of the articles in the selected impact journals.

Participants will not receive any economical compensation for taking part in this study.

Author information

Author notes

  1. Sara Ares-Blanco and Marina Guisado-Clavero shared first authorship.

  2. Raquel Gómez-Bravo and Maria Pilar Astier-Peña shared last authorship.

Authors and Affiliations

  1. Federica Montseny Health Centre, Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain

    Sara Ares-Blanco & Lourdes Ramos Del Rio

  2. Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain

    Sara Ares-Blanco

  3. SemFYC representative in EGPRN (European General Practitioner Research Network), Madrid, Spain

    Sara Ares-Blanco

  4. Investigation Support Multidisciplinary Unit for Primary Health Care and Community North Area of Madrid, Madrid, Spain

    Marina Guisado-Clavero

  5. World Organization of Family Doctors (WONCA) Chief Executive Officer, Brussels, Belgium

    Charilaos Lygidakis

  6. Las Cortes Health Centre, Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain

    María Fernández-García

  7. semFYC Vice-Chair, Madrid, Spain

    María Fernández-García

  8. Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

    Davorina Petek

  9. EGPRN, Brussels, Belgium

    Davorina Petek

  10. Department of Family Medicine, Faculty of Medicine, Tel Aviv University and WONCA Europe President, Tel Aviv, Israel

    Shlomo Vinker

  11. World Organization of Family Doctors (WONCA) Past president, Brussels, Belgium

    Donald Li

  12. World Organization of Family Doctors (WONCA) President, Brussels, Belgium

    Anna Stadval

  13. Universidad Miguel Hernández, Elche, Spain

    José Joaquín Mira Solves

  14. Fundación de Investigación e Innovación Biosanitaria de Atención Primaria (FIIBAP), Madrid, Spain

    Ileana Gefaell Larrondo

  15. Red de Investigación de Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Barcelona, Spain

    Ileana Gefaell Larrondo

  16. Member of Irish College of General Practice (MICGP), Member of Royal College of Physician (MRCSI), Dublin, Ireland

    Louise Fitzgerald

  17. Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Limor Adler

  18. Department Urology and General Practice, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria

    Radost Assenova

  19. Research Unit for General Medicine and Primary Health Care, Faculty of Medicine, School of Health Science, University of Ioannina, Ioannina, Greece

    Maria Bakola

  20. Department of General Practice, University of Lille, Lille, France

    Sabine Bayen

  21. General Medicine Department, Belarusian State Medical University, Minsk, Belarus

    Elena Brutskaya-Stempkovskaya

  22. Spiru Haret” University, Occupational Health Expert, Practicing family doctor, Bucharest, Romania

    Iliana-Carmen Busneag

  23. Health Centre Zagreb West and Department of Family Medicine, University of Zagreb, Zagreb, Croatia

    Asja Ćosić Divjak, Miroslav Hanževački & Goranka Petricek

  24. Department of Geriatric Medicine, Hôpitaux Robert Schuman, Luxembourg, Luxembourg

    Maryher Delphin Peña

  25. School of Social Sciences, Hellenic Open University, Patra, Greece

    Philippe-Richard Domeyer

  26. Center for family medicine, Medical faculty Skopje, Skopje, North Macedonia

    Dragan Gjorgjievski

  27. Capio Kvillebäcken Health Centre, Gothenburg, Sweden

    Mila Gómez-Johansson

  28. General Practice and Primary Care, Med. University of Vienna, Vienna, Austria

    Kathryn Hoffmann

  29. Department of Family Medicine and Outpatient Care, Medical Faculty 2, Uzhhorod National University, Uzhhorod, Ukraine

    Oкcaнa Iлькoв & Shushman Ivanna

  30. Health center Krupa na Uni, Republic of Srpska, Bosanska Kupra, Bosnia and Herzegovina

    Marijana Jandrić-Kočić

  31. Medical Department, Medical Education Unit, Laboratory of Hygiene and Epidemiology, Faculty of Health Sciences, University of Ioannina- Greece. GHS, Larnaca, Cyprus

    Vasilis Trifon Karathanos

  32. Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, North Macedonia

    Aleksandar Kirkovski

  33. Health center Kraljevo, Kraljevo, Serbia

    Snežana Knežević

  34. Van Gürpınar District Public Hospital, Istambul, Turkey

    Büsra Çimen Korkmaz

  35. Dr Đorđe Kovačević Health Center, Lazarevac, Belgrade, Serbia

    Milena Kostić

  36. Department of Family Medicine, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland

    Anna Krztoń-Królewiecka

  37. Comprehensive Health Research Center, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal

    Bruno Heleno

  38. USF das Conchas, Regional Health Administration Lisbon and Tagus Valley, Lisbon, Portugal

    Bruno Heleno

  39. Department of Family Medicine, UJCM at Uniwersytet Jagielloński - Collegium Medicum, Krakow, Poland

    Katarzyna Nessler

  40. Hannover Medical School, Center for Public Health and Healthcare, Hannover, OE, Germany

    Heidrun Lingner

  41. Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, Vilnus, Lithuania

    Liubovė Murauskienė

  42. Imperial College London, London, UK

    Ana Luisa Neves

  43. Faculty of Medicine, University of Porto, Porto, Portugal

    Ana Luisa Neves

  44. Närhälsan Kungshöjd Health Centre, Gothenburg, Sweden

    Naldy Parodi López

  45. Department of Clinical Pharmacology, Sahlgrenska University Hospital, Gothenburg, Sweden

    Naldy Parodi López

  46. Department of Family Medicine at the University of Semmelweis, Budapest, Hungary

    Ábel Perjés

  47. Department of Clinical Sciences in Malmö, Centre for Primary Health Care Research, Lund University, Malmö, Sweden

    Ferdinando Petrazzuoli

  48. European Parliament, Luxembourg, Luxembourg

    Martin Sattler

  49. PZU Femilihelt, Skopje, North Macedonia

    Natalija Saurek-Aleksandrovska

  50. Charles University, First Faculty of Medicine, Institute of General Practice, Prague, Czech Republic

    Bohumil Seifert

  51. Azienda Unità Sanitaria Locale di Modena, Laboratorio EduCare, University of Modena and Reggio Emilia, Modena, Italy

    Alicia Serafini

  52. Center for Public Health and Healthcare, Hannover Medical School, Hannover, Germany

    Theresa Sentker

  53. Communicable Diseases and Infection Control Unit, City of Vantaa, Vantaa and University of Helsinki, Helsinki, Finland

    Paula Tiili & Kirsi Valtonen

  54. Department of Family Medicine, Semmelweis University, Budapest, Hungary

    Péter Torzsa

  55. Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium

    Bert Vaes

  56. Academisch Centrum voor Huisartsgeneeskunde KU Leuven Kapucijnenvoer, Leuven, Belgium

    Gijs van Pottebergh

  57. CHNP, Rehaklinik, Ettelbruck, Luxembourg

    Raquel Gómez-Bravo

  58. Department of Behavioural and Cognitive Sciences, Research Group Self-Regulation and Health, Institute for Health and Behaviour, Faculty of Humanities, Education, and Social Sciences, Luxembourg University, WONCA SIGFV Executive, SSLMG Executive, Luxembourg, Luxembourg

    Raquel Gómez-Bravo

  59. Universitas Health Centre, Public Health Service of Aragon, Zaragoza, Spain

    Maria Pilar Astier-Peña

  60. Chair of Patient Safety Working Group of Semfyc (Spanish Society for Family and Community Medicine) and and SECA (Spanish Society for Healthcare Quality) Board Member, Madrid, Spain

    Maria Pilar Astier-Peña

Authors
  1. Sara Ares-Blanco
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  2. Marina Guisado-Clavero
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  3. Charilaos Lygidakis
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  4. María Fernández-García
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  5. Davorina Petek
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  6. Shlomo Vinker
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  7. Donald Li
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  8. Anna Stadval
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  9. José Joaquín Mira Solves
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  10. Lourdes Ramos Del Rio
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  11. Ileana Gefaell Larrondo
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  12. Louise Fitzgerald
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  13. Limor Adler
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  14. Radost Assenova
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  15. Maria Bakola
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  16. Sabine Bayen
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  17. Elena Brutskaya-Stempkovskaya
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  18. Iliana-Carmen Busneag
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  19. Asja Ćosić Divjak
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  20. Maryher Delphin Peña
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  21. Philippe-Richard Domeyer
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  22. Dragan Gjorgjievski
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  23. Mila Gómez-Johansson
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  24. Miroslav Hanževački
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  25. Kathryn Hoffmann
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  26. Oкcaнa Iлькoв
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  27. Shushman Ivanna
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  28. Marijana Jandrić-Kočić
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  29. Vasilis Trifon Karathanos
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  30. Aleksandar Kirkovski
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  31. Snežana Knežević
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  32. Büsra Çimen Korkmaz
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  33. Milena Kostić
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  34. Anna Krztoń-Królewiecka
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  35. Bruno Heleno
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  36. Katarzyna Nessler
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  37. Heidrun Lingner
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  38. Liubovė Murauskienė
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  39. Ana Luisa Neves
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  40. Naldy Parodi López
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  41. Ábel Perjés
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  42. Ferdinando Petrazzuoli
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  43. Goranka Petricek
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  44. Martin Sattler
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  45. Natalija Saurek-Aleksandrovska
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  46. Bohumil Seifert
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  47. Alicia Serafini
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  48. Theresa Sentker
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  49. Paula Tiili
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  50. Péter Torzsa
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  51. Kirsi Valtonen
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  52. Bert Vaes
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  53. Gijs van Pottebergh
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  54. Raquel Gómez-Bravo
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  55. Maria Pilar Astier-Peña
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Contributions

SAB, MGC, RGB and MPAP are Family Doctors and one of them is as well Preventive Medicine and Public Health specialist. They are very involved in the Spanish Scientific Society of Family and Community Medicine (semFYC). They have published recently three papers analysing the role of PHC during this pandemic in Spain and in Europe. In this context, SAB, RGB and MPAP made an extensive analysis of COVID-19 resources and organization worldwide observing a lack of PHC data, highlighting the need to collect this information. MGC has joint the initial group and helped to carry out the analysis of the European Union data set. SAB, RGB, MPA and MGC have contributed equally in drafting the manuscript, analysing and interpreting of data. CL, MFG, DP, SV, DL, AS, JJMS, LRDR, IGL, LF, LA, RA, MB, SB, EBS, ICB, AĆD, MDP, PRD, DG, MGJ, MH, KH, ОІ, SI, MJK, VTK, AK, SK, BÇK, MK, AKK, BH, KN, HL, LM, ALN, NPL, ÁP, FP, GP, MS, NSA, BS, AS, TS, PTi, PTo, KV, BV and GvP have read critically the draft and made substantial intellectual contributions, endorsing the key messages transmitted and approving the final version to be published. SAB, RGB and MPA have supervised all the process.

Corresponding author

Correspondence to Raquel Gómez-Bravo.

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The authors declare no competing interests.

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Ares-Blanco, S., Guisado-Clavero, M., Lygidakis, C. et al. Exploring the accessibility of primary health care data in Europe's COVID-19 response: developing key indicators for managing future pandemics (Eurodata study). BMC Prim. Care 25, 221 (2024). https://doi.org/10.1186/s12875-024-02413-5

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Keywords

BMC Primary Care

ISSN: 2731-4553

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