Access barriers and the role of central coordination: Long COVID-19 healthcare in Austria, 2025, Gamillscheg et al

[Wyva]

P Gamillscheg, A Laszewska, K Hoffmann, J Simon, S Mayer

Abstract​

Background
Long COVID-19 patients experience a multitude of complex symptoms for an extended time, therefore often requiring increased medical care. Despite the global incidence of around 400 million (2023), little is known about potential issues related to healthcare access. This study analyses healthcare access barriers and facilitators encountered by long COVID-19 patients in the universal Austrian healthcare system and assesses the role of central coordination units in potentially alleviating the patient burden.

Methods
Data collection via survey 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 were used in the statistical analysis.

Results
Long COVID-19 patients encountered barriers 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 doctors due to lacking expertise in the public sector and difficulties in treating symptoms by GPs and specialists (over 85%). Although the overall burden remained high, participants in federal states offering central coordination to the existing facilities encountered statistically significantly fewer barriers, particularly regarding the availability of services in the public sector and incurred costs. Main facilitators were the patient's social environment and the (information) exchange with other patients.

Conclusions
While the study finds severely impeded healthcare access for long COVID-19 patients in Austria, it supports the introduction of central coordination units and further research assessing the implementation of long COVID-19 pathways to improve patients’ healthcare access.

Key messages

• Long COVID-19 patients in Austria face widespread and severe access barriers, especially due to the burden of self-organising one’s treatment and lack of expertise within the public system.

• Given the availability of sufficient services allowing for care coordination, central coordination shows promise in easing access to care for long COVID-19 patients in a universal healthcare system.

Open access: https://academic.oup.com/eurpub/article/35/Supplement_4/ckaf161.1181/8303085
PDF (abstract only)

 

[rvallee]

Despite the global incidence of around 400 million (2023), little is known about potential issues related to healthcare access.

This fake naivete doesn't do the authors of this study any service. It's the most well-known issue, in fact. It's universally terrible. This is why every single news article and report is either all or mostly about that. This is a lot like a meteorologist saying they have no idea how the weather is outside right now because they don't have enough data, when they can simply turn their heads to look out the window right beside them. In fact no they would need to be standing outside to get close enough as an analogy, it's too ridiculously Dr Magoo.

We need medical professionals to do better than this awful aww shucks tactic, it looks especially ghoulish when you consider the absolute confidence that weakly supports all the false claims made about it and the people it affects. So many MDs have so confidently asserted that none of this would ever be a problem, and not a damn person has faced any consequences for it because every single institution has bought it in full.

While the study finds severely impeded healthcare access for long COVID-19 patients in Austria, it supports the introduction of central coordination units and further research assessing the implementation of long COVID-19 pathways to improve patients’ healthcare access.

This is such an oddly constructed phrase. This shouldn't be a "while x, there is also y" when y is just a reframing of x as an opposing viewpoint. Which is a fact, there is a near total gap between the needs of this patient population and the systems and professionals who are technically responsible for it. We keep telling them they are failing miserably. They keep tut-tutting us to shut up about it.

Given the availability of sufficient services allowing for care coordination, central coordination shows promise in easing access to care for long COVID-19 patients in a universal healthcare system.

And this too. It reads so oddly, and it's not a language problem. It's just a reframing that entirely avoids the uncomfortable truths, that health care systems and medicine have completely botched this not just from day 1 but for decades prior, and have not taken any meaningful steps to simply do the most basic things that are needed, and as a consequence millions of lives have been and continue to be ruined for absolutely no valid reason.

An entire system that is incapable of telling simple truths, especially about itself. An issue about which not a single person anywhere in the world is responsible for. It's genuinely hard to even conceive of a truly worse system. Just as bad? Easy. Worse? Not without being more explicitly illegal than it already is, it would need explicitly sadistic measures to achieve it.

The turd has been so thoroughly polished that there isn't a single atom left. But the polishing never ends.