Stengel Sandra, Roth Catharina, Breckner Amanda, Peters-Klimm Frank, Schwill Simon, Möllinger Sophia, Buhlinger-Göpfarth Nicola, Szecsenyi Joachim, Wensing Michel
Abteilung Allgemeinmedizin und Versorgungsforschung, UniversitätsKlinikum Heidelberg,Heidelberg, Deutschland.
75181 Pforzheim, Gemeinschaftspraxis Dr. Nicola Buhlinger-Göpfarth & Dr. Eleonore Fritz, Pforzheim, Deutschland.
Gesundheitswesen. 2021 Apr;83(4):250-257. doi: 10.1055/a-1397-7527. Epub 2021 Mar 19.
The aim of this study was to give an early snapshot of primary care strategies that were implemented to cope with the early period of the COVID-19 pandemic in Baden-Wuerttemberg (Germany).
In June 2020, all 271 outpatient SARS-CoV-2 contact points, established by the National Association of Statutory Health Insurance Physicians (16 centers for testing, 204 specialized family practices, 51 Outpatients Corona Centers), and a randomly generated sample of 400 primary care practices of Baden-Wuerttemberg were invited to take part in a paper-based questionnaire. The data were gathered anonymously and analysed descriptively.
Out of those invited, n=63 (15.8%) primary care practices and n=92 (33.9%) SARS-CoV-2 contact points participated; 78.7% of the primary care practices cooperated with SARS-CoV-2 contact points (n=48). In all, 92.1% had implemented a compulsory registration by phone for patients with (suspected) COVID-19 (n=58) and 81% offered consultation exclusively by phone or video in case of a mild courses (n=51). The new outpatient SARS-CoV-2 contact points were established in collaboration with several stakeholders, mainly led by primary care physicians (n=76, 82.6%) and almost 50% of these were established in March 2020 (n=42, 48.3%). The most commonly reported method of registration was regulated mainly by primary care practices (n=88, 95.7%) and public health departments (n=74, 80.4%). In 92.4% (n=85) of cases, it was possible to register by phone. The consultation response was most commonly given in the form of oral information to the patient (n=65, 77.4%). Less then 50% of the SARS-CoV-2 contact points used standardized sheets for registration, documentation and consultation. The assessment of future primary care structures for (suspected) COVID-19 patients were heterogeneous.
Effort, improvisation and collaboration were required for a successful and rapid implementation of measures for primary care during the initial period of the COVID-19 pandemic. Impulses for ongoing development of primary care strategies during a pandemic can be derived out of these results.
本研究旨在对德国巴登-符腾堡州为应对新冠疫情初期而实施的初级保健策略进行早期概述。
2020年6月，邀请了由法定医疗保险医师全国协会设立的所有271个门诊新冠病毒接触点（16个检测中心、204个专科家庭诊所、51个门诊新冠中心）以及从巴登-符腾堡州随机抽取的400个初级保健诊所参与纸质问卷调查。数据以匿名方式收集并进行描述性分析。
在受邀对象中，有63个（15.8%）初级保健诊所和92个（33.9%）新冠病毒接触点参与；78.7%的初级保健诊所与新冠病毒接触点合作（48个）。总体而言，92.1%的机构对（疑似）新冠患者实施了电话强制登记（58个），81%的机构在轻症情况下仅通过电话或视频提供咨询（51个）。新的门诊新冠病毒接触点是与多个利益相关方合作设立的，主要由初级保健医生主导（76个，82.6%），其中近50%于2020年3月设立（42个，48.3%）。最常报告的登记方式主要由初级保健诊所（88个，95.7%）和公共卫生部门（74个，80.4%）规定。在92.4%（85个）的情况下，可以通过电话登记。咨询回复最常见的形式是向患者提供口头信息（65个，77.4%）。不到50%的新冠病毒接触点使用标准化表格进行登记、记录和咨询。对（疑似）新冠患者未来初级保健结构的评估存在差异。
在新冠疫情初期，成功快速实施初级保健措施需要付出努力、进行临时应对和开展合作。这些结果可为疫情期间初级保健策略的持续发展提供动力。
