gms | German Medical Science

20. Deutscher Kongress für Versorgungsforschung

Deutsches Netzwerk Versorgungsforschung e. V.

06. - 08.10.2021, digital

„I have never examined a child in the parking lot before – yes, it has changed radically”. Results of a qualitative interview study on pediatric outpatient care in the COVID-19 pandemic

Meeting Abstract

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  • Janina Curbach - Institut für Epidemiologie und Präventivmedizin/Medizinische Soziologie, Universität Regensburg, Regensburg, Deutschland
  • Eva-Maria Grepmeier - Institut für Epidemiologie und Präventivmedizin/Medizinische Soziologie, Universität Regensburg, Regensburg, Deutschland; Institut für Sozialmedizin und Gesundheitssystemforschung, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland
  • Julia von Sommoggy - Institut für Epidemiologie und Präventivmedizin/Medizinische Soziologie, Universität Regensburg, Regensburg, Deutschland

20. Deutscher Kongress für Versorgungsforschung (DKVF). sine loco [digital], 06.-08.10.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. Doc21dkvf194

doi: 10.3205/21dkvf194, urn:nbn:de:0183-21dkvf1944

Veröffentlicht: 27. September 2021

© 2021 Curbach et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

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Background: The COVID-19 pandemic and its consequences also affect standard pediatric outpatient care. Up until today, there is no research on how German pediatricians in outpatient care perceive changes in their routine healthcare work due to the pandemic.

Goal: The study aims to explore the subjective views of pediatricians on changes in their professional actions (organization of practice and patient care) in the COVID-19 pandemic.

Methods: We conducted 19 qualitative semi-standardized telephone interviews with pediatricians in outpatient care in Bavaria and North Rhine-Westphalia. The interviews were audio-recorded, transcribed verbatim and analyzed based on qualitative content analysis (Kuckartz 2012) using computer assisted qualitative data analysis software (Atlas.ti, V8).

Results: COVID-19 infection protection measures induce substantial changes in the pediatricians’ work, such as wearing PPE, separating (potentially) infectious and non-infectious patients and re-structuring the scheduling of appointments and the practice setting. Some interviewees emphasize that re-structuring measures have set positive impulses and that they intend to keep to the new routines after the pandemic. Some pediatricians find it difficult to wear face masks when communicating with infants/babies and with children with psychosocial problems.

With regard to COVID-19-related health information, the pediatricians feel well-informed by the Robert-Koch-Institute, the Association of SHI Physicians and informal exchanges with colleagues – but less well informed by local health authorities. The interviewees find it challenging to constantly re-adjust their professional position and practices based on the rapidly changing official recommendations. This also makes it difficult to communicate COVID-19-related information to their (often insecure) patients.

The pediatricians report to be especially concerned about a changed (degree of capacity) utilization: Preventive examinations are utilized almost as before the pandemic, however, parental fear of visiting the practice and infection protection measures in the children’s living environments have led to a significant decline in utilization for mild infections. While some pediatricians appreciate this sudden drop in utilization to be a relief of workload, others experience severe financial distress. Few interviewees report to see more children with psychosocial problems, one expects an increase in allergic conditions in the future caused by the current absence of mild infections.

Discussion: The work of pediatricians has changed due to COVID-19 infection protection measures, an insecure information situation and a decline in (utilization for) mild infections. Future observations will show if a shift in types of diseases and in healthcare utilization will have lasting effects on the scope of duties of pediatricians in outpatient care.

Practice implications: The decline in healthcare utilization for mild infections and the resulting financial distress calls for health policy measures in order to ensure comprehensive pediatric care in the future. Positive experiences with re-structuring the pediatric practice (settings) should be spread as “best practices”.