Report on Erasmus MC and C-support research
That post-COVID care in the Netherlands is not yet optimal was already partly apparent from previous research by the Erasmus MC in collaboration with C-Support among patients. Now the perspective of the healthcare professionals themselves has been investigated. 169 professionals who are (in)directly involved in this care participated in a so-called Delphi study; through questionnaires and reflections with experts, opinions were collected on various aspects of care. Bottlenecks such as the lack of proven treatments, recognition and understanding, knowledge and multidisciplinary collaboration were clearly identified. 1/3 of the participants do not have sufficient options to provide good treatment and 1/4 assesses post-COVID care in general as 'poor'. The collaboration between healthcare professionals is given a 5,5. Agreement on the most important bottlenecks to be resolved has often not been reached. This shows how complex the content and organization of post-COVID care is. There is still a lot of room for improvement, the recently opened centers of expertise will contribute to this.
According to the participants, important bottlenecks in healthcare are the lack of understanding and recognition of patients and the unavailability of medicines and evidence-based treatments. The latter in particular is not expected to change in the short term by the (healthcare) professionals involved. Scientific research and multidisciplinary collaboration are important conditions for solving the aforementioned bottlenecks. At the time the questionnaires were administered (October 2023 and May 2024), the centers of expertise had not yet opened and their set-up was still unknown. Expectations among the participants are high and these centers are seen as a solution to many of the bottlenecks. The future will have to show whether this will actually be the case.
Division of tasks and knowledge
The general practitioner is given an important role. As a diagnostician, primary care provider and case manager. However, the participating general practitioners themselves see their role as smaller. Gathering knowledge through research and sharing both new and existing knowledge is seen as important for further improvements in post-COVID care. The need for more knowledge and thus a perspective for action is great. Guideline development is very slow, but guidelines and handouts are seen by the participants of this study as an important way of transferring knowledge.
Cooperation and finance
The mutual collaboration between healthcare professionals in post-COVID care is given a pass mark (5,5) by the participants in this study. Bottlenecks here are high workload, lack of capacity and time, lack of multidisciplinary collaboration and lack of reimbursement for consultation. According to the participants, the bottlenecks are difficult to resolve. A major financial barrier is the lack of financing for healthcare providers and the lack of policy, rates and contracted care from health insurers.
Annemieke de Groot, director of C-support:
“Despite previous lessons from Q fever care, insufficient progress has been made in the recognition and acknowledgement and organisation of care for complex post-infectious conditions (PAIS). This emphasises the need to consider what is needed in the event of new outbreaks of zoonoses and/or infectious diseases and to learn from the past.”
C-support: optimizing post-COVID care
Based on the results of this study, C-support advocates that the parties involved take responsibility for the development and improvement of post-COVID care. In healthcare, collaboration, multidisciplinary working methods, coordination of care, acquiring knowledge and a broad view of all areas of life should be central. In addition, it is desirable that care is organised close to the patient. This requires strong primary and secondary care. Recognition forms the basis for good care and knowledge is an indispensable tool to improve this care. Healthcare professionals must have the right information and resources to be able to help post-COVID patients effectively. According to C-support, investing in education, research and awareness is essential.
Below you will find the link to the report, the appendix, the cover letter and the link to the easy-to-read summary that has been created for professionals and other interested parties.
Summary of the report
