[Barriers and facilitators to accessing healthcare during the pandemic: an assessment of healthcare managers and professionals].

OBJECTIVE: To gain insight into the experiences of healthcare managers and professionals during the COVID-19 pandemic, with the aim of identifying barriers and facilitators to healthcare access for chronic patients. LOCATION: Aragon Health System (SALUD), Aragon, Spain. PARTICIPANTS: 21 managers and 16 healthcare professionals (nurses and doctors) selected using convenience and snowball sampling. METHODS: A qualitative research design involving semi-structured interviews and communicative focus groups based on a communicative methodology was employed. Perceptions were collected regarding barriers to access, the quality of care, digitalisation, territorial inequality, the availability and management of resources, as well as positive experiences and lessons learned. RESULTS: Three main barriers were identified that hindered equitable access to care, especially for vulnerable patients: the digital divide, rural-urban inequality, and system overload. Among the facilitating factors, digitalisation and interdisciplinary collaboration were found to improve efficiency and coordination between levels of care. The experiences gathered revealed discrepancies between organisational decisions and clinical outcomes, particularly in the care of chronic patients. CONCLUSIONS: The pandemic revealed both structural weaknesses in the health system and opportunities for improvement. Positive innovations must be consolidated through an equitable approach that is tailored to the needs of vulnerable patients.