AUTHOR=Litke Nicola , Weber Sophia , Breckner Amanda , Roth Catharina , Peters-Klimm Frank , Wensing Michel , Stengel Sandra TITLE=Resilience of the primary healthcare system: perspectives of German stakeholders at primary care interfaces during the second wave of the COVID-19 pandemic JOURNAL=Frontiers in Medicine VOLUME=11 YEAR=2024 URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1322765 DOI=10.3389/fmed.2024.1322765 ISSN=2296-858X ABSTRACT=Introduction

Worldwide, the primary care sector played a key role in coping with the challenges of the SARS-CoV-2 pandemic.

Methods

The aim of this study was to explore the resilience of the German primary healthcare system during the second wave of the pandemic from the perspective of identified interface stakeholders, i.e., representatives of hospitals, district offices, and medical associations. Qualitative data from interviews and focus groups were analyzed according to a resilience framework.

Results

The main findings include a gap in knowledge transfer, unstructured allocation of responsibilities, and a resulting unregulated flow of patients. Social brokers supported care coordination and knowledge transfer. The response to the capacity to cope with uncertainties was slow and chaotic at the system level and heterogeneous at the individual level. Building on previous relationships fostered functioning communication, while competition in primary care was identified as a barrier to resilience.

Conclusion

Implications for further research and for strengthening the resilience of primary care can be derived based on this study.