{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T14:30:34Z","timestamp":1773153034958,"version":"3.50.1"},"reference-count":30,"publisher":"Elsevier BV","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:00:00Z","timestamp":1760054400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Carlos III Health Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.es","elsevier.es","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Atenci\u00f3n Primaria"],"published-print":{"date-parts":[[2026,1]]},"DOI":"10.1016\/j.aprim.2025.103402","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T14:35:29Z","timestamp":1767882929000},"page":"103402","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Barreras y elementos facilitadores en el acceso a la atenci\u00f3n sanitaria durante la pandemia de COVID-19: valoraci\u00f3n de gestores y profesionales sanitarios"],"prefix":"10.1016","volume":"58","author":[{"given":"Irantzu","family":"Bengoa-Urrengoechea","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel","family":"Aguilar-Palacio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana","family":"Valero-Errazu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Jos\u00e9","family":"Rabanaque","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u00aa Jos\u00e9","family":"G\u00f3mez-Poyato","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u00aa Antonia","family":"S\u00e1nchez-Calavera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Malo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1016\/j.aprim.2025.103402_bib0155","first-page":"1","article-title":"World Health Organization. The impact of the COVID-19 pandemic on noncommunicable disease resources and services: results of a rapid assessment","year":"2020","journal-title":"WHO."},{"key":"10.1016\/j.aprim.2025.103402_bib0160","doi-asserted-by":"crossref","first-page":"759","DOI":"10.15585\/mmwr.mm6924e2","article-title":"Coronavirus Disease 2019 Case Surveillance - United States, January 22-May 30, 2020","volume":"69","author":"Stokes","year":"2020","journal-title":"Morb Mortal Wkly Rep."},{"key":"10.1016\/j.aprim.2025.103402_bib0165","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12875-020-01278-8","article-title":"Primary care in the time of COVID-19: Monitoring the effect of the pandemic and the lockdown measures on 34 quality of care indicators calculated for 288 primary care practices covering about 6 million people in Catalonia","volume":"21","author":"Coma","year":"2020","journal-title":"BMC Fam Pract."},{"issue":"Suppl Extr 3","key":"10.1016\/j.aprim.2025.103402_bib0170","first-page":"1","article-title":"El paciente con diabetes mellitus tipo 2 durante la pandemia de covid-19","volume":"12","author":"Carretero Anibarro","year":"2021","journal-title":"Diabetes Pr\u00e1ctica."},{"key":"10.1016\/j.aprim.2025.103402_bib0175","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1136\/bmjdrc-2020-001413","article-title":"Impact of type 2 diabetes and microvascular complications on mortality and cardiovascular outcomes in a multiethnic Asian population","volume":"9","author":"Yap","year":"2021","journal-title":"BMJ Open Diabetes Res Care."},{"key":"10.1016\/j.aprim.2025.103402_bib0180","first-page":"1","article-title":"Psychological Impact of COVID-19 on Health Workers During the Second Year of the Pandemic in Latin America: Cross-Sectional Survey Study","volume":"13","author":"Banse","year":"2023","journal-title":"Int J Environ Res Public Health."},{"key":"10.1016\/j.aprim.2025.103402_bib0185","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph20032428","article-title":"Occupational Burnout in Healthcare Workers, Stress and Other Symptoms of Work Overload during the COVID-19 Pandemic in Poland","volume":"20","author":"Izdebski","year":"2023","journal-title":"Int J Environ Res Public Health."},{"key":"10.1016\/j.aprim.2025.103402_bib0190","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.cnur.2021.11.006","article-title":"Comparison of Nurse Burnout, Before and During the COVID-19 Pandemic","volume":"57","author":"Sullivan","year":"2022","journal-title":"Nurs Clin North Am."},{"key":"10.1016\/j.aprim.2025.103402_bib0195","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.medcli.2021.04.003","article-title":"Estr\u00e9s laboral y burnout en los m\u00e9dicos residentes, antes y durante la pandemia por COVID-19: una puesta al d\u00eda","volume":"157","author":"Navin\u00e9s","year":"2021","journal-title":"Med Clin (Barc)."},{"key":"10.1016\/j.aprim.2025.103402_bib0200","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1038\/s41591-021-01381-y","article-title":"Health systems resilience in managing the COVID-19 pandemic: lessons from 28 countries","volume":"27","author":"Haldane","year":"2021","journal-title":"Nat Med [Internet]."},{"key":"10.1016\/j.aprim.2025.103402_bib0205","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1177\/1077800410397802","article-title":"Critical Communicative Methodology: Informing Real Social Transformation Through Research","volume":"17","author":"G\u00f3mez","year":"2011","journal-title":"Qual Inq [Internet]."},{"key":"10.1016\/j.aprim.2025.103402_bib0210","doi-asserted-by":"crossref","first-page":"6848","DOI":"10.3390\/su12176848","article-title":"How Much Is One Life Worth? The Right to Equity Healthcare for Improving Older Patients\u2019 Health Infected by COVID-19","volume":"12","author":"Merodio","year":"2020","journal-title":"Sustainability [Internet]."},{"key":"10.1016\/j.aprim.2025.103402_bib0215","doi-asserted-by":"crossref","first-page":"4483","DOI":"10.3390\/ijerph19084483","article-title":"Mental Health and Access to Information in Times of COVID-19: The Role of Social Work","volume":"19","author":"Romea","year":"2022","journal-title":"Int J Environ Res Public Health [Internet]."},{"key":"10.1016\/j.aprim.2025.103402_bib0220","first-page":"1","article-title":"Instituto Nacional de Estad\u00edstica","volume":"2022","year":"2022","journal-title":"Encuesta sobre Equipamiento y Uso de Tecnolog\u00edas de Informaci\u00f3n y Comunicaci\u00f3n en los Hogares A\u00f1o 2022"},{"key":"10.1016\/j.aprim.2025.103402_bib0225","article-title":"Cronicidad y estrategias de e-Salud: La importancia del perfil digital","year":"2024","journal-title":"Plataforma de organizaci\u00f3n de pacientes [Internet]."},{"key":"10.1016\/j.aprim.2025.103402_bib0230","article-title":"V\u00edas y lugares de atenci\u00f3n primaria durante la pandemia en una zona rural de Alicante","volume":"37","author":"P\u00e9rez-Fern\u00e1ndez","year":"2023","journal-title":"Gac Sanit [Internet]."},{"key":"10.1016\/j.aprim.2025.103402_bib0235","doi-asserted-by":"crossref","first-page":"185","DOI":"10.23938\/ASSN.0945","article-title":"Local perception of access to health services in rural areas. The case of the Navarrese Pyrenees","volume":"44","author":"Sanz","year":"2021","journal-title":"An Sist Sanit Navar [Internet]."},{"key":"10.1016\/j.aprim.2025.103402_bib0240","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1111\/j.1440-1584.2008.00953.x","article-title":"Addressing the health disadvantage of rural populations: How does epidemiological evidence inform rural health policies and research?","volume":"16","author":"Smith","year":"2008","journal-title":"Aust J Rural Health [Internet]."},{"key":"10.1016\/j.aprim.2025.103402_bib0245","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1093\/fampra\/cmg422","article-title":"Rural health around the world: challenges and solutions*","volume":"20","author":"Strasser","year":"2003","journal-title":"Fam Pract [Internet]."},{"key":"10.1016\/j.aprim.2025.103402_bib0250","article-title":"Aten\u00e7\u00e3o prim\u00e1ria \u00e0 sa\u00fade em \u00e1reas rurais: acesso, organiza\u00e7\u00e3o e for\u00e7a de trabalho em sa\u00fade em revis\u00e3o integrativa de literatura","volume":"37","author":"Franco","year":"2021","journal-title":"Cad Saude Publica [Internet]."},{"key":"10.1016\/j.aprim.2025.103402_bib0255","doi-asserted-by":"crossref","first-page":"749","DOI":"10.17269\/s41997-022-00630-y","article-title":"Social, political, commercial, and corporate determinants of rural health equity in Canada: an integrated framework","volume":"113","author":"Leimbigler","year":"2022","journal-title":"Can J Public Heal [Internet]."},{"key":"10.1016\/j.aprim.2025.103402_bib0260","doi-asserted-by":"crossref","first-page":"1798","DOI":"10.1186\/s12889-024-19282-3","article-title":"The impact of hospital saturation on non-COVID-19 hospital mortality during the pandemic in France: a national population-based cohort study","volume":"24","author":"Boyer","year":"2024","journal-title":"BMC Public Health [Internet]."},{"key":"10.1016\/j.aprim.2025.103402_bib0265","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1186\/s12875-023-02086-6","article-title":"COVID-19 pandemic has disrupted the continuity of care for chronic patients: evidence from a cross-sectional retrospective study in a developing country","volume":"24","author":"Dehghani Tafti","year":"2023","journal-title":"BMC Prim Care [Internet]."},{"key":"10.1016\/j.aprim.2025.103402_bib0270","doi-asserted-by":"crossref","first-page":"575","DOI":"10.2147\/RMHP.S293471","article-title":"The Effects of the Health System Response to the COVID-19 Pandemic on Chronic Disease Management: A Narrative Review","volume":"14","author":"Kendzerska","year":"2021","journal-title":"Risk Manag Healthc Policy [Internet]."},{"key":"10.1016\/j.aprim.2025.103402_bib0275","article-title":"Effectiveness of digital health interventions for chronic conditions management in European primary care settings: Systematic review and meta-analysis","volume":"196","author":"Ambrosi","year":"2025","journal-title":"Int J Med Inform [Internet]."},{"key":"10.1016\/j.aprim.2025.103402_bib0280","article-title":"Digital health and equitable access to care","volume":"3","author":"Shaw","year":"2024","journal-title":"PLoS Digit Heal [Internet]"},{"key":"10.1016\/j.aprim.2025.103402_bib0285","article-title":"Barriers to and Facilitators of Digital Health Among Culturally and Linguistically Diverse Populations: Qualitative Systematic Review","volume":"25","author":"Whitehead","year":"2023","journal-title":"J Med Internet Res [Internet]."},{"key":"10.1016\/j.aprim.2025.103402_bib0290","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1080\/13561820.2022.2061928","article-title":"Encountering uncertainty and complexity in decision-making: an observational study of clinical reasoning among medical and interprofessional groups of health care students","volume":"37","author":"Berger","year":"2023","journal-title":"J Interprof Care [Internet]."},{"issue":"Suppl 10","key":"10.1016\/j.aprim.2025.103402_bib0295","first-page":"S284","article-title":"Integrated delivery systems: the cure for fragmentation","volume":"15","author":"Enthoven","year":"2009","journal-title":"Am J Manag Care [Internet]."},{"key":"10.1016\/j.aprim.2025.103402_bib0300","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1111\/jan.15865","article-title":"Interprofessional clinical decision-making process in health: A scoping review","volume":"80","author":"Bouchez","year":"2024","journal-title":"J Adv Nurs [Internet]."}],"container-title":["Atenci\u00f3n Primaria"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S021265672500188X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S021265672500188X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T22:45:01Z","timestamp":1773096301000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S021265672500188X"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":30,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["S021265672500188X"],"URL":"https:\/\/doi.org\/10.1016\/j.aprim.2025.103402","relation":{},"ISSN":["0212-6567"],"issn-type":[{"value":"0212-6567","type":"print"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Barreras y elementos facilitadores en el acceso a la atenci\u00f3n sanitaria durante la pandemia de COVID-19: valoraci\u00f3n de gestores y profesionales sanitarios","name":"articletitle","label":"Article Title"},{"value":"Atenci\u00f3n Primaria","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.aprim.2025.103402","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier Espa\u00f1a, S.L.U.","name":"copyright","label":"Copyright"}],"article-number":"103402"}}