PRICOV-19 STUDY: A cross-sectional study in 38 countries on the organization of care in general practices during the COVID-19 pandemic

Focus on primary care in times of COVID-19

The COVID-19 pandemic emphasizes the need for strong, well-organized, and integrated health care systems. The PRICOV-19 study was set up to investigate how GP practices reorganized during the COVID-19 pandemic to guarantee safe, effective, patient-centered, and equitable care. Also, the shift in roles and tasks between care providers and the wellbeing of staff is researched. Thanks to its scale and multi-country design, PRICOV-19 also can study which practice- and health care system characteristics are associated with better care and with how GP practices cope with COVID-19 related challenges. 

The results will inform policymakers on which features of health systems and general practice organization must be reinforced to prepare primary care systems across Europe against future pandemics. After all, increased attention to patient safety can limit the transmission not only of COVID-19 but also of other infectious diseases.  

An exceptional collaboration between 45 research institutes

PRICOV-19 was initiated in the summer of 2020. Under the coordination of 'Quality and Safety Ghent,' an interdisciplinary center of expertise for quality and safety in primary care and transdisciplinary care within the Department of Public Health and Primary Care at Ghent University (Belgium), an international consortium of more than 45 research institutes was formed. The study was set up in close collaboration with the 'European Association for Quality and Patient Safety in Primary Care' (EQuiP), one of the WONCA networks. 

PRICOV-19 is the only study at this scale focusing on the organization of primary care in times of COVID-19.  

An online survey to collect data in 38 countries

Data were collected following a cross-sectional study design and using an online questionnaire sent to general practices in 37 European countries and Israel. More than 4.700 practices participated in this study:

card participants

The questionnaire includes 53 items divided into six sections: 

  • - patient flow (including appointments, triage, and management for routine care);
  •  - infection prevention; 
  • - information processing; 
  • - communication; 
  • - collaboration and self-care; 
  • - practice and participant characteristics.

Questionnaire data are linked with OECD and HSMR data regarding national policy responses to the pandemic and analyzed using multilevel models considering the system- and practice-level. 

More information on the study protocol can be found here.

Progress of the study

Data collection is finished in all countries. For each of the following research domains, the data is now being analyzed by interdisciplinary teams of experts from different partner institutions. Reports and publications on the following topics are expected soon: 

  • infection control and prevention; 
  • patient safety incidents; 
  • the use of video consultations; 
  • limitations to the practice infrastructure and building; 
  • care for vulnerable patients; 
  • screening for domestic violence; 
  • change of roles; - the wellbeing of GPs; 
  • differences between teaching practices for GP trainees and non-teaching practices; 
  • methodological insights for multi-country studies including differences according to the used sampling procedures. 

Several country-specific reports are in preparation.


The PRICOV-19 study has almost entirely been funded by in-kind contributions by the partnering institutions. Additional support was received from EGPRN (COVID-19 Grant Funding).

Publications and presentations

Reference to the protocol paper of the PRICOV-19 study: 

  • Van Poel, E., Vanden Bussche, P., Klemenc-Ketis, Z. et al. How did general practices organize care during the COVID-19 pandemic: the protocol of the cross-sectional PRICOV-19 study in 38 countries. BMC Prim. Care 23, 11 (2022). 

Publications on the national PRICOV-19 databases: 

  • Paper on the results in the Netherlands: Groenewegen, P., van den Muijsenbergh, M., Batenburg, R., Van Poel, E., Schaubroeck, E., Stark, S., van den Broek, S., Vanden Bussche, P., Willems, S. (2021). Aanpassingen in de organisatie van de zorg in huisartspraktijken tijdens de COVID-19 pandemie. Manuscript submitted for publication. 
  • Paper on the results in Israel: Adler, L., Vinker, S., Heymann, A.D., Van Poel, E., Willems, S., Zacay, G. (2021). The effect of the COVID-19 pandemic on primary care physicians in Israel, with comparison to an international cohort: a cross-sectional study. Manuscript submitted for publication. 

The overview of the publications will be regularly updated on this website.


Results of PROCOV-19 were presented at the following conferences: 

  • Willems, S., Van Poel, E., Vanden Bussche, P., Collins, C., Eide, T., Jacobsen, F. F., … van den Muijsenbergh, M. (2021). COVID-19 : threat or opportunity for quality improvement (QI) in primary care? In EFPC 2021 16th Conference, Abstracts. Virtual. 
  • Willems, S., Van Poel, E., Vanden Bussche, P., & Klemenc-Ketiš, Z. (2021). COVID-19 : threat or opportunity for quality improvement in primary care in Europe. In 12th International Symposium on Health Sciences, Abstracts. Virtual. 
  • Willems, S., Van Poel, E., Vanden Bussche, P., Klemenc-Ketiš, Z., Rochfort, A., & Zwart, D. (2021). COVID-19 : threat or opportunity for quality improvement in general practice? In 26th WONCA Europe Conference, Abstracts. Virtual.

More information

Please contact the Ghent University PRICOV-19 team: 

Partnering institutions

More information