Table 1.

An mini overview of studies' outcomes conducted in Europe regarding to quality of healthcare during COVID-19.

References	Country	Scope of health services	Study design and methodology	Outcome
Coma et al. (11)	Catalonia	Primary care	A retrospective descriptive study was conducted in the 288 primary care practices (PCP) of the Institut Català de la Salut. The study period was the first 4 months of 2019 and 2020. For this study, 34 quality indicators of different types were included: adequacy of treatment (4 indicators), follow-up of chronic diseases (5), control of chronic diseases (10), screening (7), vaccinations (4) and quaternary prevention (4).	A negative effect was observed on 85% of the quality indicators in March and 68% in April. 90% of the control indicators had a negative impact, highlighting the control of LDL cholesterol and blood pressure control. The indicators with the most significant negative effect were screening, such as the indicator of diabetic foot screening.
Fieux et al. (12)	France	Otolaryngology—telemedicine	A prospective study was performed in the otolaryngology department of a university hospital center. A satisfaction survey was carried out over a 7-day inclusion period during lockdown among 100 patients. The questionnaire consisted of 12 questions.	Overall satisfaction was 87%. The sound quality was judged poorly or unsatisfactory by 24% of patients and video quality by 39%. On the other hand, 94% of patients agreed or ultimately agreed that communication was accessible.
Danhieux et al., 2020 (13)	Belgium	Chronic care	A qualitative study was conducted in 16 primary care practice among twenty-one people (doctors, nurses, dieticians) who were interviewed, using semi-structured video interviews.	Changes in organization with a collective shift toward COVID-19 care, and reduction of chronic care activities, less consultations, and staff responsible for self-management support put on hold, in ensuring quality chronic care were observed.
de Joode et al. (14)	Netherlands	Oncology	The patients' perspective on oncology care was investigated using an online survey, consisted of 20 questions between March 29th 2020 and April 18th 2020. Five thousand three hundred two patients with cancer completed the survey.	Patients with delay (55%) and discontinuation (63%) of treatment, were very concerned about these consequences of the COVID-19 pandemic.
Brislane et al., 2021 (15)	United Kingdom, Ireland	Obstetric care	Between May 3rd and June 28th, 2020, 314 women from the United Kingdom and 23 from Ireland validated the questionnaire to quantify healthcare quality using the 46-item Quality of Prenatal Care Questionnaire (QPCQ).	72% of women report good quality of care.
Golinelli et al. (16)	Italy	Orthopedic	The retrospective cohort study included 5,379 patients with hip fractures. Surgery rate, surgery timeliness, length of hospital stay, timely rehabilitation, and 30-day mortality for each patient were analyzed. Data was evaluated monthly (2020 vs. 2019).	There was a significant increase in the proportion of patients that did not undergo timely surgery and a substantial increase in mortality.
Key et al., 2021 (17)	United Kingdom	General Health	A single-center patient experience survey was conducted among 704 patients across the Cardiff and Vale University Health Board. The quality of care was assessed on a scale of 1 to 10.	The mean score for quality of care was 9 (with ten being the highest). The majority of patients reported that they believed adequate staff in the hospital to care for them (66% always, 21% often).
Kludacz-Alessandri et al. (18)	Poland	Primary care—telemedicine	The data was collected during two sessions: on February 25th 2021–February 26th 2021 and March 11th 2021–March 12th 2021 through an anonymous questionnaire assessing the quality of primary medical care among 98 patients.	Patients rated primary healthcare services during the COVID-19 pandemic through telemedicine quite highly.
Lakshin et al. (19)	Germany	Pediatric surgery—telemedicine	A cross-sectional analysis using three surveys between 6/2020 and 10/2020 was conducted based on anonymous survey among 81 pediatric's surgeons and 86 families with telemedical appointments at the Department of Pediatric Surgery of the University Hospital of Frankfurt.	91% of the surgeons providing telephone visits think that patients are satisfied with the service, 89% of those with video visits, and the rest could not tell; 96% of the patients found the connection quality during their telephone consultations sufficient. 97% experienced no technical problems during the call. When asked to compare a telemedical visit to a traditional, in-person one, 33% found it inferior, 44% found it to be equal, 4% said it was superior while 19% could not tell.
Douiri et al. (20)	United Kingdom	Stroke care	A registry-based cohort study of patients with acute stroke admitted to hospitals in England, Wales, and Northern Ireland between October 1st, 2019, and April 30th, 2020, and equivalent periods in the three prior years.	Care quality was maintained or improved for all care quality (e.g., Brain scan within 1 h; swallow screen within 4 h; direct admission to Stroke Unit within 4 h; stroke specialist physician assessment within 24 h).
Nymark et al. (21)	Sweden	Cardiology	The MISSCARE Survey-Swedish version was conducted among 43 registered nurses and nurse assistants at a cardiology department. The data were compared with a reference sample–59 registered nurses and nurse assistants at a cardiology department who filled a baseline survey conducted in October 2019.	Significant differences were found between the COVID-19 and the reference sample concerning the perception of patient safety and quality of care. The nursing staff in the COVID-19 sample perceived the quality of care to be lower than those in the reference sample (85.7% vs. 98.3%, p = 0.04).
Kanavaki et al. (22)	United Kingdom	Nephrology	The observational study using mixed-methods study involving kidney patients, their significant others and 8 Healthcare Professionals (HCP) conducted by psychologist.	Most participants found the challenges of remote patient assessment and monitoring unsatisfactory; there were delays in patients receiving appropriate treatment leading to sub-optimal care; more than one in three participants described difficulties in HCP-patient communication.