COVID-19 and quality of care in Belgian general practices compared to 36 other European countries: results from the international cross-sectional PRICOV-19 study

Background: COVID-19 confronted general practices with unprecedented challenges to provide high-quality care. This paper aims to: (1) assess how Belgian general practices acted upon the six dimensions of quality of care during COVID-19; (2) study differences between the three Belgian regions; and (3) benchmark the performance of Belgian practices against the performance in other European countries.Methods: Data were collected in 2020–2021 using a self-administered survey in 479 Belgian practices. Thirty-four survey questions were selected as outcome variables. The adjusted logistic regression models included four practice characteristics as covariates: practice type, being a teaching practice, multidisciplinarity, and payment system. Benchmarking against the performance in 36 other participating European countries was done for each outcome variable.Results: 77.6% of Belgian practices reported incidents related to timely care. Limitations to the practice building or infrastructure threatened high-quality care in 55.6% of the practices. 57.2% always used a cleaning protocol, 38.5% provided sufficient time to disinfect between consultations, or a separate doctor bag for infection-related home visits (27.9%). Most (54.8%) Belgian practices actively reached out to vulnerable patients. Many significant differences between the Belgian regions disappeared when adjusting for practice characteristics. Belgium ranked relatively high on the European level for most outcome variables on safety and effectiveness. Regarding person-centeredness, equity, and efficiency, a scattered pattern was found. Regarding timely care, Belgium ranked in the lowest quarter of European countries.Conclusion: Future studies using different design methods are crucial to gain in-depth insights into the underlying mechanisms of ensuring high-quality care.Background: COVID-19 confronted general practices with unprecedented challenges to provide high-quality care. This paper aims to: (1) assess how Belgian general practices acted upon the six dimensions of quality of care during COVID-19; (2) study differences between the three Belgian regions; and (3) benchmark the performance of Belgian practices against the performance in other European countries.Methods: Data were collected in 2020–2021 using a self-administered survey in 479 Belgian practices. Thirty-four survey questions were selected as outcome variables. The adjusted logistic regression models included four practice characteristics as covariates: practice type, being a teaching practice, multidisciplinarity, and payment system. Benchmarking against the performance in 36 other participating European countries was done for each outcome variable.Results: 77.6% of Belgian practices reported incidents related to timely care. Limitations to the practice building or infrastructure threatened high-quality care in 55.6% of the practices. 57.2% always used a cleaning protocol, 38.5% provided sufficient time to disinfect between consultations, or a separate doctor bag for infection-related home visits (27.9%). Most (54.8%) Belgian practices actively reached out to vulnerable patients. Many significant differences between the Belgian regions disappeared when adjusting for practice characteristics. Belgium ranked relatively high on the European level for most outcome variables on safety and effectiveness. Regarding person-centeredness, equity, and efficiency, a scattered pattern was found. Regarding timely care, Belgium ranked in the lowest quarter of European countries.Conclusion: Future studies using different design methods are crucial to gain in-depth insights into the underlying mechanisms of ensuring high-quality care.