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新冠疫情期间的跨专业初级保健:提供者视角调查。

Interprofessional primary care during COVID-19: a survey of the provider perspective.

机构信息

Queen's University, 31 George Street, Kingston, Ontario, K7L 3N6, Canada.

University of Toronto, 246 Bloor Street, Toronto, Ontario, M5S 1V4, Canada.

出版信息

BMC Fam Pract. 2021 Feb 3;22(1):31. doi: 10.1186/s12875-020-01366-9.

Abstract

BACKGROUND

Interprofessional primary care (IPC) teams provide comprehensive and coordinated care and are ideally equipped to support those populations most at risk of adverse health outcomes during the COVID-19 pandemic, including older adults, and patients with chronic physical and mental health conditions. There has been little focus on the experiences of healthcare teams and no studies have examined IPC practice during the early phase of the COVID-19 pandemic. The objective of the study was to describe the state of interprofessional health provider practice within IPC teams during the COVID-19 pandemic.

METHODS

Observational cross-sectional design. A web-based survey was deployed to IPC providers working in team-based primary care clinics in the province of Ontario, Canada. The survey included 26 close-ended and six open-ended questions. Close-ended questions were analyzed using descriptive statistics. Content analysis was used to analyze the open-ended questions.

RESULTS

445 surveys were included in the final analysis. Service delivery shifted from in-person care (77% pre-COVID-19) to telephone (76.5% during the COVID-19 pandemic). Less than half of the respondents (40%) reported receiving any training for virtual delivery. Wait times to access team members were reported to have decreased. There has also been a shift in what IPC providers report as the most commonly seen conditions, with increases in visits related to mental health concerns, acute infections (including COVID-19), social isolation, and resource navigation. Respondents also reported a reduction in healthcare provision for multiple chronic conditions including diabetes, cardiovascular disease, and chronic pain.

CONCLUSIONS

IPC teams are rapidly shifting their practice to supporting their patients during the pandemic. A surge in mental health issues has been seen and is expected to continue to increase in response to COVID-19. Understanding early experiences can help plan for future pandemic waves.

摘要

背景

跨专业初级保健(IPC)团队提供全面且协调的护理,非常适合为在 COVID-19 大流行期间最有可能出现不良健康结果的人群提供支持,包括老年人以及患有慢性身心健康疾病的患者。很少关注医疗保健团队的经验,也没有研究在 COVID-19 大流行的早期阶段检查 IPC 实践。本研究的目的是描述 COVID-19 大流行期间 IPC 团队内跨专业卫生提供者实践的状况。

方法

观察性横断面设计。一项基于网络的调查被部署到在安大略省基于团队的初级保健诊所工作的 IPC 提供者。该调查包括 26 个封闭式和 6 个开放式问题。封闭式问题采用描述性统计进行分析。采用内容分析法分析开放式问题。

结果

最终分析纳入了 445 份调查。服务交付从面对面护理(COVID-19 前为 77%)转变为电话(COVID-19 期间为 76.5%)。不到一半的受访者(40%)报告接受过任何虚拟交付培训。与团队成员联系的等待时间据称已减少。IPC 提供者报告的最常见病症也发生了转变,与心理健康问题、急性感染(包括 COVID-19)、社会隔离和资源导航相关的就诊次数有所增加。受访者还报告称,多种慢性疾病的医疗服务减少,包括糖尿病、心血管疾病和慢性疼痛。

结论

IPC 团队正在迅速调整其实践,以在大流行期间为患者提供支持。心理健康问题激增,预计随着 COVID-19 的发展,这一问题将继续增加。了解早期经验有助于为未来的大流行浪潮做好计划。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f005/7860035/3d8cfee53b8e/12875_2020_1366_Fig1_HTML.jpg

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