Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerpen, Belgium
Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerpen, Belgium.
BMJ Open. 2020 Jun 17;10(6):e039674. doi: 10.1136/bmjopen-2020-039674.
The current COVID-19 pandemic, as well as the measures taken to control it, have a profound impact on healthcare. This study was set up to gain insights into the consequences of the COVID-19 outbreak on the core competencies of general practice, as they are experienced by general practitioners (GPs) on the frontline.
DESIGN, SETTING, PARTICIPANTS: We performed a descriptive study using semistructured interviews with 132 GPs in Flanders, using a topic list based on the WONCA definition of core competencies in general practice. Data were analysed qualitatively using framework analysis.
Changes in practice management and in consultation strategies were quickly adopted. There was a major switch towards telephone triage and consults, for covid-related as well as for non-covid related problems. Patient-centred care is still a major objective. Clinical decision-making is largely focused on respiratory assessment and triage, and GPs feel that acute care is compromised, both by their own changed focus and by the fact that patients consult less frequently for non-covid problems. Chronic care is mostly postponed, and this will have consequences that will extend and become visible after the corona crisis. Through the holistic eyes of primary care, the current outbreak-as well as the measures taken to control it-will have a profound impact on psychological and socioeconomic well-being. This impact is already visible in vulnerable people and will continue to become clear in the medium and long terms. GPs think that they are at high risk of getting infected. Dropping out and being unable to contribute their part or becoming virus transmitters are reported to be greater concerns than getting ill themselves.
The current times have a profound impact on the core competences of primary care. Although the vast increase in patients soliciting medical help and the necessary separate covid and non-covid flows have been dealt with, GPs are worried about the continuity of regular care and the consequences of the anticovid measures. These may become a threat for the general health of the population and for the provision of primary healthcare in the near and distant future.
当前的 COVID-19 大流行以及为控制疫情而采取的措施对医疗保健产生了深远的影响。本研究旨在深入了解 COVID-19 爆发对全科医生核心能力的影响，这些影响是前线全科医生的亲身体验。
设计、地点、参与者：我们使用基于 WONCA 对全科医学核心能力定义的主题清单，对佛兰德的 132 名全科医生进行了描述性研究，采用半结构化访谈。使用框架分析对数据进行定性分析。
实践管理和咨询策略的变化很快被采用。对于与 COVID-19 相关和非 COVID-19 相关的问题，电话分诊和咨询的比例大幅上升。以患者为中心的护理仍然是一个主要目标。临床决策主要集中在呼吸评估和分诊上，而且全科医生认为急性护理受到了影响，这既是因为他们自己的关注点发生了变化，也是因为患者对非 COVID-19 问题的咨询频率降低。慢性病护理大多被推迟，这种情况将在冠状病毒危机后持续并显现出来。通过初级保健的整体视角，当前的疫情以及为控制疫情而采取的措施将对心理和社会经济福祉产生深远的影响。这种影响在弱势群体中已经显现，并将在中长期内继续显现。全科医生认为他们感染的风险很高。无法工作或成为病毒传播者的风险比自己生病的风险更令人担忧。
当前的情况对初级保健的核心能力产生了深远的影响。尽管已经处理了大量寻求医疗帮助的患者以及必要的 COVID-19 和非 COVID-19 分流，但全科医生仍担心常规护理的连续性以及抗 COVID-19 措施的后果。这些可能会对人口的一般健康和近期及远期的初级医疗保健服务提供构成威胁。
