Laboratorio de Hígado, Páncreas y Motilidad (HIPAM), Unidad de Investigación en Medicina Experimental, Facultad de Medicina-Universidad Nacional Autónoma de México (UNAM), Gastroenterología y Endoscopía, Centro Médico ABC, Gastroenterología y Motilidad Gastrointestinal, Clínica Lomas Altas SC.
Unidad de Investigación en Medicina Experimental, Facultad de Medicina-Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico.
J Clin Gastroenterol. 2021 Sep 1;55(8):684-690. doi: 10.1097/MCG.0000000000001413.
BACKGROUND: The COVID-19 pandemic has affected medical practice in fields not related to the infection. Neurogastroenterology is a subspecialty of gastroenterology focused on motility and functional gastrointestinal disorders, including consultations, and conducting procedures (eg, endoscopies, manometries/pH-monitoring). AIM: The aim of this study was to determine the impact of COVID-19 on Neurogastroenterology in Latin America. METHODS: Members of the Latin American Society of Neurogastroenterology were invited by e-mail and social networks to participate in an online anonymous survey. It included 24 questions on demographics, clinical practice and procedure characteristics, impact of the pandemic, Telemedicine, and involvement in COVID-19 patient care. RESULTS: Sixty-one members mainly from Colombia, Mexico, and Brazil answered the survey. All reported a negative impact on their practice (88.6%: a 61% to 100% decrease), mainly in office consultations and elective endoscopies. Interestingly, emergency endoscopies decreased by 33.3%, while only 4% stopped performing manometries/pH-monitoring. The main reasons were patients' fear for consulting, country's lockdown, and physician's decision to prevent infection spread. Telemedicine was implemented by 83% but only 64.7% were being remunerated. Almost 46% had to reduce salaries and working hours of their personnel. Fifty-nine percent had colleagues diagnosed with COVID-19, 24.6% were involved in these patients' care, and 11.5% were mobilized to COVID-19 wards. There were country differences: Colombia, lockdown (P=0.001); Mexico, COVID-19 patient-care (P=0.053); Mexico/Colombia, working in COVID-19 wards, (P=0.012); Brazil, less common elective procedures' ban (P=0.012) and Telemedicine/reimbursement (P=0.034). CONCLUSIONS: The COVID-19 pandemic has negatively impacted the practice and wellness of Neurogastroenterologists in Latin America. Guidelines to resume activities and policies for Telemedicine practice and reimbursement are warranted.
背景:COVID-19 大流行不仅对感染相关领域的医疗实践产生了影响,还对非感染相关领域的医疗实践产生了影响。神经胃肠病学是胃肠病学的一个分支,专注于运动和功能性胃肠疾病,包括咨询和进行操作(例如内镜检查、测压/ pH 监测)。
目的:本研究旨在确定 COVID-19 对拉丁美洲神经胃肠病学的影响。
方法:通过电子邮件和社交网络邀请拉丁美洲神经胃肠病学学会的成员参与在线匿名调查。该调查包括 24 个问题,涉及人口统计学、临床实践和操作特征、大流行的影响、远程医疗以及参与 COVID-19 患者护理等方面。
结果:共有 61 名主要来自哥伦比亚、墨西哥和巴西的成员回答了调查。所有人都报告说他们的实践受到了负面影响(88.6%:减少了 61%至 100%),主要是在门诊咨询和择期内镜检查方面。有趣的是,急诊内镜检查减少了 33.3%,而只有 4%停止进行测压/ pH 监测。主要原因是患者担心咨询、国家封锁以及医生决定防止感染传播。83%的人实施了远程医疗,但只有 64.7%的人获得了报酬。近 46%的人不得不减少人员工资和工作时间。59%的人有同事被诊断出患有 COVID-19,24.6%的人参与了这些患者的护理,11.5%的人被调动到 COVID-19 病房。各国之间存在差异:哥伦比亚,封锁(P=0.001);墨西哥,COVID-19 患者护理(P=0.053);墨西哥/哥伦比亚,在 COVID-19 病房工作(P=0.012);巴西,较少禁止择期手术(P=0.012)和远程医疗/报销(P=0.034)。
结论:COVID-19 大流行对拉丁美洲神经胃肠病学家的实践和健康产生了负面影响。有必要制定恢复活动的指南以及远程医疗实践和报销的政策。
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