Abstract

Background

In Germany, general practitioners (GPs) provide basic and primary care in the ambulatory sector and refer patients to other specialists when necessary. Often, GPs present the first point of contact for patients in the German healthcare system. During the COVID-19 pandemic, GPs and other medical specialists in the ambulatory setting suddenly were confronted with unprecedented challenges.

Objective

To answer the following research questions: How did COVID-19-related challenges affect the work climate? Do physicians with deteriorated work climate simultaneously report a worsened provision of patient care? Which challenges were the most burdening?

Methods

In the course of the project COVID-GAMS more than 18 000 physicians of various specialties had been invited to a quantitative cross-sectional online survey (in Summer 2020). Analyses were conducted separately for the groups of GPs and other medical specialists. Group differences were analysed statistically and burdening factors were identified.

Results

1703 participants were included in the analysis. 22.2% of GPs (other medical specialists: 19.9%) stated, their work climate had deteriorated. Physicians with a deteriorated work climate showed a tendency towards poorer personal provision of patient care (M = 3.75, SD = 0.98 versus M = 3.93, SD = 0.99) compared to unchanged or improved work climate. The lack of protective material in March/April 2020, changes in practice management and possible economic impacts on the practice were the most burdening factors reported by GPs.

Conclusion

GPs who reported a negative impact on the work climate in the course of the first pandemic lockdown also tend to see own deficits in the provision of patient care.

中文翻译：

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大流行时期的工作环境：德国医生在初级保健中报告了哪些负担？

摘要

背景

在德国，全科医生 (GP) 在门诊部门提供基本和初级保健，并在必要时将患者转诊给其他专科医生。通常，全科医生是德国医疗系统中患者的第一个接触点。在 COVID-19 大流行期间，门诊环境中的全科医生和其他医学专家突然面临前所未有的挑战。

客观的

回答以下研究问题：与 COVID-19 相关的挑战如何影响工作环境？工作环境恶化的医生是否同时报告患者护理提供恶化？哪些挑战是最沉重的？

方法

在 COVID-GAMS 项目的过程中，超过 18,000 名不同专业的医生被邀请参加一项定量横断面在线调查（2020 年夏季）。对全科医生和其他医学专家组分别进行分析。对组间差异进行统计分析并确定负担因素。

结果

1703 名参与者被纳入分析。22.2% 的全科医生（其他医学专家：19.9%）表示，他们的工作环境已经恶化。与未改变或改善的工作环境相比，工作环境恶化的医生表现出对患者护理的个人提供更差的趋势（M = 3.75，SD = 0.98 对M = 3.93，SD = 0.99）。2020 年 3 月/4 月缺乏防护材料、实践管理的变化以及对实践的可能经济影响是全科医生报告的最沉重的负担因素。

结论

在第一次大流行封锁期间报告对工作环境产生负面影响的全科医生也倾向于看到自己在提供患者护理方面存在缺陷。