初级保健医生关于常见的传染病投诉的决策趋势
Anat Reiner-Benaim1, Shimon Amar2
1Department of Epidemiology, Biostatistics and Community Health Sciences, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er-Sheva, Israel.
Infectious diseases (London, England)
|April 22, 2024
概括
在COVID-19期间,初级保健医生面临不确定性,但保持了临床决策. 社会限制减少了转诊和抗生素处方,改善了护理质量并预防了抗生素耐药性.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 主要护理医学 医疗保健
背景情况:
- 由于诊断有限和转向远程医疗,COVID-19大流行给初级保健医生 (PCP) 带来了挑战.
- 在疫情期间,PCPS经历了临床决策的不确定性增加,特别是在呼吸评估方面.
研究的目的:
- 评估大流行对PCP决策的影响,特别是胸部X射线,实验室测试和抗生素处方的转诊.
- 分析2018年至2022年间以色列南部初级保健医生临床决策模式的变化.
主要方法:
- 一项回顾性研究分析了以色列南部209家诊所 (2018-2022) 发烧或咳的609,823次初级保健访问.
- 多变量通用线性混合效应模型被用于比较疫情前,疫情前和疫情后期间的转诊和处方率,控制各种因素.
主要成果:
- 在COVID-19期间的社会限制与所有测量结果中的转诊和抗生素处方减少有关.
- 在封锁期间,喉培养转诊 (OR=0.46) 和脑素处方 (OR=0.55) 显著减少,特别是在20-59岁的成年人中.
- 这些趋势甚至在限制解除后继续存在.
结论:
- 初级保健医生保持了临床决策过程,尽管与大流行相关的不确定性.
- 流行病相关的限制导致辅助资源利用率下降,可能提高患者护理质量.
- 减少抗生素处方和诊断测试可以降低医疗保健成本,并有助于预防未来的抗生素耐药性.
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