Javanparast Sara, Roeger Leigh, Reed Richard L
Department of General Practice, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.
Aust Health Rev. 2021 May;45:525-532. doi: 10.1071/AH20328.
Objective This study investigated the experience of patients with chronic diseases regarding access to and utilisation of multidisciplinary care during COVID-19 in South Australia. Methods Telephone interviews were conducted with 30 patients with chronic conditions attending nine general practices in metropolitan Adelaide. Supplementary data were obtained from the Medicare Benefit Schedule (MBS) to compare health services activity data provided by different health professionals before and after COVID-19 (from January 2019 to June 2020). Results There was variation in access to different health services by patients with chronic conditions during COVID-19. The introduction of telehealth facilitated continuity of general practitioner (GP) services, with a high level of satisfaction among patients. Changes in medicines regulation, including the home delivery of medications, enabled timely access to medications for patients. The use of telehealth was less common for specialist and particularly allied health services. Dental check-ups that are important for the management of some chronic conditions were disrupted the most during COVID-19. Conclusion The findings of this study suggest that the policy measures introduced in Australia provided an opportunity to maintain multidisciplinary care for patients with chronic diseases during COVID-19. GPs, as core members of the primary healthcare team, as well as pharmacy and pathology services, were highly accessible. Telehealth was less accessed for chronic care services provided by specialists and allied health professionals. What is known about the topic? Access to multidisciplinary care is critical to ensure continuity and quality of care for patients with chronic health conditions. Evidence suggests disruptions in health services can occur during pandemics. To continue access to routine care, the Australian Government introduced several policy initiatives during COVID-19 to enhance access to multidisciplinary care. What does this paper add? Telehealth policy was particularly effective in facilitating patients' access to general practice services during COVID-19 particularly those services that did not need physical examinations. This policy complemented changes in medicines regulations that enabled timely and convenient access to medications for patients with chronic conditions. Allied health services, as important elements of multidisciplinary care, were more likely to be disrupted during COVID-19. What are the implications for practitioners? Continuation of telehealth services is likely to enhance access to general practice services. The acceptability and use of telehealth for allied health services may require more flexibility, and training for both practitioners and patients.
目的 本研究调查了南澳大利亚州慢性病患者在新冠疫情期间获得和利用多学科护理的经历。方法 对阿德莱德都会区9家全科诊所的30名慢性病患者进行了电话访谈。从医疗保险福利计划（MBS）获取补充数据，以比较新冠疫情前后（2019年1月至2020年6月）不同医疗专业人员提供的医疗服务活动数据。结果 慢性病患者在新冠疫情期间获得不同医疗服务的情况存在差异。远程医疗的引入促进了全科医生（GP）服务的连续性，患者满意度较高。药品监管的变化，包括药品送货上门，使患者能够及时获得药品。远程医疗在专科服务尤其是辅助医疗服务中的使用不太普遍。对某些慢性病管理很重要的牙科检查在新冠疫情期间受到的干扰最大。结论 本研究结果表明，澳大利亚出台的政策措施为新冠疫情期间慢性病患者维持多学科护理提供了机会。全科医生作为初级医疗团队的核心成员，以及药房和病理服务，都很容易获得。专科医生和辅助医疗专业人员提供的慢性病护理服务较少采用远程医疗。关于该主题已知的情况是什么？获得多学科护理对于确保慢性病患者护理的连续性和质量至关重要。有证据表明，大流行期间医疗服务可能会中断。为了继续获得常规护理，澳大利亚政府在新冠疫情期间推出了多项政策举措，以增加获得多学科护理的机会。本文补充了什么内容？远程医疗政策在促进患者在新冠疫情期间获得全科医疗服务方面特别有效，尤其是那些不需要体格检查的服务。这项政策补充了药品监管方面的变化，使慢性病患者能够及时、方便地获得药品。辅助医疗服务作为多学科护理的重要组成部分，在新冠疫情期间更容易受到干扰。对从业者有什么影响？继续提供远程医疗服务可能会增加获得全科医疗服务的机会。辅助医疗服务对远程医疗的接受度和使用可能需要更大的灵活性，以及对从业者和患者的培训。
