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Archives of Public Health

Barriers, facilitators, and the role of central coordination: understanding long COVID-19 healthcare access in a universal healthcare system

Published in:
Authors
Peter Gamillscheg-Müllner
Agata Łaszewska
Kathryn Hoffmann
Judit Simon
Susanne Mayer
Published in
Archives of Public Health | Issue 1/2025

Abstract

Background

This study comprehensively analyses healthcare access barriers and facilitators encountered by long COVID-19 patients in a universal healthcare system, including the potential role of central coordination units in alleviating the patient burden.

Study design

Retrospective cross-sectional long COVID-19 patient questionnaire survey.

Methods

Data collection took place 10–12/2024 in Austria (n = 433). Conceptualized along the five steps of the ‘access to care’ framework, the questionnaire covered 47 barriers and 10 facilitators derived from a previous qualitative study. Descriptive statistics, Whitney-Mann-U and t-tests, as well as linear and ordered logistic regressions were used in the statistical analysis.

Results

Barriers were encountered in all access steps with the mean number of barriers considered problematic being 31.9 (SD 8.4) out of 47. The most common barriers were lacking information and the burden of self-organising one’s treatment (perceived as problematic by over 90%), followed by the need to consult private (non-contracted) doctors due to insufficient expertise in the public sector and difficulties in treating symptoms by GPs and specialists (85%). Participants living in federal states offering central coordination encountered statistically significantly fewer barriers, perceiving a mean of 17.4 barriers (SD 9.7) as very problematic compared to 21.0 (SD 9.2). Differences were particularly pronounced regarding the availability of services within the public sector and incurred costs although the overall burden remained high. Main facilitators included family and friends and the (information) exchange with other patients.

Conclusions

Our findings have important policy and research implications beyond the Austrian context, supporting the establishment of central coordination units and research assessing the effectiveness and implementation of long COVID-19 pathways to improve patients’ healthcare access.
Title
Barriers, facilitators, and the role of central coordination: understanding long COVID-19 healthcare access in a universal healthcare system
Authors
Peter Gamillscheg-Müllner
Agata Łaszewska
Kathryn Hoffmann
Judit Simon
Susanne Mayer
Publication date
01-12-2025
Publisher
BioMed Central
Published in
Archives of Public Health / Issue 1/2025
Electronic ISSN: 2049-3258
DOI
https://doi.org/10.1186/s13690-025-01783-1
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