描述加拿大COVID-19大流行前和期间的初级保健模式:使用基于国家实践的研究网络数据进行准实验性的前后设计队列研究
Shuaib Hafid1, Karla Freeman1, Kris Aubrey-Bassler2
1Family Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
BMJ open
|May 21, 2024
概括
由于COVID-19大流行,慢性病管理的个人初级保健服务减少了,更少的患者接受血压测量和实验室测试. 然而,总的来说,初级保健所遇到的情况保持一致,显示了护理交付方法的转变.
科学领域:
- 公共卫生 公共卫生
- 主要护理医学 医疗保健
- 流行病学 流行病学
背景情况:
- 全球范围内,COVID-19大流行严重扰乱了医疗保健系统.
- 初级保健对于治疗慢性疾病至关重要,需要持续的获取和全面的服务.
- 了解大流行对初级保健的影响对于未来的卫生系统弹性至关重要.
研究的目的:
- 分析COVID-19大流行对初级保健准入和慢性疾病管理综合性的影响.
- 为了比较COVID-19大流行早期和早期的初级保健利用模式.
主要方法:
- 进行了一项准实验性的前后设计队列研究.
- 利用来自加拿大初级保健哨兵监测网络 (2018-2021) 的电子医疗记录数据.
- 包括超过919,928名与初级保健接触的成年患者,分析准入 (遭遇,血压测量,实验室测试) 和全面性 (诊断,疫苗,转诊) 指标.
主要成果:
- 在大流行期间,较少的患者有初级护理接触 (91.5%至81.5%),尽管获得护理的人的接触数中位数保持稳定.
- 观察到个人护理指标的显著下降,血压测量 (47.9%至31.8%) 和实验室测试的减少.
- 面对面护理指标的趋势与国家COVID-19病例数量暂时相关.
结论:
- 虽然总体上维持了初级保健接触,但大流行导致了慢性疾病管理必不可少的面对面服务减少.
- 具体的个人护理指标的下降凸显了大流行期间服务交付的转变.
- 调查结果强调,需要制定战略,确保在公共卫生紧急情况下继续获得全面的初级保健.
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