Identifying essential COVID-19 indicators for primary healthcare through Delphi analysis in 31 European countries: Eurodata eDelphi study

Background The COVID-19 pandemic has underlined the essential role of primary healthcare (PHC) in epidemiological surveillance and public health decision-making. Across Europe, the integration of electronic health records (EHRs) and the sentinel networks have been pivotal in monitoring COVID-19. However, the lack of standardized PHC indicators for COVID-19 hinders the comparability of data among countries. Objective To establish a consensus on a set of standardized PHC activity indicators related to the COVID-19 pandemic for 31 countries, enhancing the capability of health authorities to make informed decisions and prepare for future health crises. Methods A two-round eDelphi study was conducted using a structured web-based survey, following the CREDES guidelines, to achieve consensus among a panel of 164 experts from the Eurodata study. 86 Indicators were selected based on their availability during the current pandemic, with participants rating the relevance and utility of proposed indicators. Results Of the 22 initial indicators, seven received consensuses for inclusion, while two remained contentious after the second round. The study found significant discrepancies in the awareness of sentinel networks and accessibility to PHC data. The consensus emphasized the necessity for indicators to be standardized, reproducible, and easily extractable from databases, with recommendations for disaggregation by age, sex, and vaccination status. Conclusion Key COVID-19 indicators for PHC were identified, reflecting a consensus among healthcare professionals. Further cooperation between PHC providers and national public health authorities is warranted both on the national and the international level to harmonized healthcare indicators in response to future health emergencies.