Access barriers and the role of central coordination: Long COVID-19 healthcare in Austria

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.