Unterstützung der ambulanten Versorgung im Pandemiefall Empfehlungen aus der Evaluation des bayerischen Versorgungsarztansatzes in der ersten Phase der COVID-19-Pandemie

Background In the early phase of the COVID-19 pandemic in spring 2020, so-called regional medical coordinators (RMCs) were deployed in Bavaria as part of the declared state of emergency in districts and independent cities to coordinate ambulatory care. The experiences were examined in an evaluation project. One aim of the project was to use the data collected to develop recommendations for supporting ambulatory care in future pandemics. Methods First, cross-sectional surveys of RMCs and general practitioners (GPs) were conducted in parallel, as well as an interview-based qualitative survey of RMCs, GPs and representatives of authorities and the Bavarian Association of Statutory Health Insurance Physicians (BASHIP). Afterwards, based on the empirical data collected and taking into account available publications and reports, recommendations for decision-makers were developed in a sequential process. Results The main recommendations are a greater consideration of ambulatory care in catastrophic and emergency situations as well as in the updating of existing emergency and pandemic plans; establishment of systematic advisory and feedback structures for policy-makers and authorities with the involvement of experienced, ambulatory physicians to avoid frictional losses; more efficient use of the existing strength in ambulatory care; pre-definition of persons, responsibilities and tasks on state, district and county level; ensuring adequate supporting infrastructure so that advisory physicians can act efficiently. Conclusions Although the recommendations were developed in the context of an evaluation project of the Bavarian RMC concept, they could be helpful for future pandemic and emergency situations, also nationwide and outside official disaster situations, if adapted to local conditions.