Impact of the COVID-19 pandemic on patient-reported patient safety in Primary Care

Abstract

Objective: To evaluate the impact of the changes introduced in response to the pandemic on patient-reported patient safety in Primary Care. Design: Prospective observational panel study (health center) based on two cross-sectional surveys. Setting: 29 Primary Health Care centers from three Spanish health regions (Mallorca, Catalunya Central and Camp de Tarragona). Participants: Random sample of patients visiting their centers before (n = 2199 patients) and during the pandemic (n = 1955 patients) Main measurements: We used the PREOS-PC questionnaire, a validated instrument which assesses patient-reported patient safety in Primary Care. We compared mean scores of the “experiences of errors” and “harm” scales in both periods, and built multilevel regression analyzes to study the variations in patient and center characteristics associated with worse levels of safety. A qualitative (content) analysis of patients’ experiences during the pandemic was also performed. Results: The “experiences of errors” and “harm” scales scores significantly worsened during the COVID-19 period (92.65 to 88.81 (Cohen's d = 0.27); and 96.92 to 79.97 (d = 0.70), respectively). Patient and center characteristics associated to worsened scores were: women, people with a lower educational level, worse health status, more years assigned to the center, and health region. Conclusions: During the pandemic, a perceptible worsening in patient safety perceived by patients treated in Primary Care has been observed, which has differentially affected patients according to their sociodemographic characteristics or health center profiles.