Vortragender:
Peter Gamillscheg, MSc
Senior Scientist | Doktorand
Abteilung für Gesundheitsökonomie

Vortragstitel: 
“Finding a GP in the public sector taking long COVID seriously is like playing the lottery": A qualitative study on access barriers and facilitators to healthcare for long COVID-19 patients in Austria”

Objectives
Long COVID-19 puts economic pressure on health and social systems globally. While overall unmet healthcare needs are minimal in Austria's two-tier Bismarck healthcare system, the novelty of this chronic post-viral condition poses an acute challenge. This study explores access barriers and facilitators encountered by long COVID-19 patients in Austria, and further aims to derive hypotheses for future research on potential socioeconomic inequalities in healthcare access.
Methods
We conducted interviews with 15 clinical and non-clinical experts and 7 focus groups with 18 long COVID-19 patients with confirmed long COVID-19 diagnosis (07-11/2023). Thematic framework analysis was employed, drawing on Levesque et al.'s (2013) patient-centered access to healthcare model.
Results
Participants identified several barriers including skepticism or stigma by medical professionals, difficulties in finding experts, limited capacity of outpatient specialists, long waiting times, closure of specialized outpatient clinics and limited health insurance coverage. Beyond high out-of-pocket payments, these issues also impacted employment, leading to long-term sick leaves, job changes and presenteeism. Facilitators included a supporting social environment, telemedicine, and informal information provided by a patient-led support group on social media. Socioeconomic differences emerged by gender, health literacy, and health insurance status: Women faced gender-based stigmatization and those with a medical background experienced an advantage in engaging with doctors. Complementary health insurance reduced the financial strain, however, was not related to shorter waiting times.
Discussion
This study is first to outline the range of barriers to access healthcare in the context of a novel chronic condition in a Bismarck healthcare system. The identified barriers might amplify health economic implications by hindering recovery, resulting in high costs to patients and health and social systems.