Menéndez Orenga Miguel, Arribas Mayordomo Miriam, Gasser Paula, Gefaell Larrondo Ileana, Giusto Laureano Brenda, Sardi Carolina, Trovina Carolina, Ares-Blanco Sara
Investigador independiente.
Instituto de investigación i+12 (CIBERESP). Hospital 12 de Octubre. Madrid. España.
Rev Esp Salud Publica. 2022 Feb 14;96:e202202018.
OBJECTIVE: Primary Care (PC) must attend and follow COVID-19 patients with mild and moderate symptoms, and identify severe cases. The aim of this study was to describe the characteristics of patients attended in PC with suspicious COVID-19 and health care provision by PC. METHODS: Retrospective longitudinal observational study of electronic health records (EHR) and agendas. Probabilistic sampling of suspicious COVID-19 patients' pathway in 5 health centers in Madrid between March 16 and 20, 2020. The variables used were sociodemographic, symptoms, examination, radiography, characteristics of schedules and professional sick leaves. Descriptive analysis and time to event (pneumonia). RESULTS: 240 EHR were reviewed. Average age 48 years, 60% women. Most frequent symptoms: cough (80%) and elevation of temperature (63%). Pneumonia appeared in 23%. 73% were bilateral. Age and male gender were related to pneumonia. 20% required admission. 7 patients died (2.9%). 19,027 COVID-19 appointments were scheduled in PC. 60% of patients were attended in PC without performing chest X-ray or assistance by other care level. 22.4% of GPs working days were absent because of sick leaves. Differences were found amongst facilities in chest X-ray requesting (max. 62%, min. 2%). The PC center with the fewest X-rays requested was the one with the major number of sick leaves. CONCLUSIONS: Age and male gender were related to pneumonia onset in PC. Health care activity was intense, and variability was found amongst facilities. Professional sick leaves could affect the quality of care.
目的:基层医疗(PC)必须诊治并跟踪症状轻微和中度的新冠患者,并识别重症病例。本研究的目的是描述基层医疗中诊治的疑似新冠患者的特征以及基层医疗提供的医疗服务情况。 方法:对电子健康记录(EHR)和日程安排进行回顾性纵向观察研究。对2020年3月16日至20日马德里5个医疗中心疑似新冠患者的诊疗路径进行概率抽样。所使用的变量包括社会人口统计学、症状、检查、影像学检查、日程安排特征和专业病假情况。进行描述性分析和事件发生时间(肺炎)分析。 结果:审查了240份电子健康记录。平均年龄48岁,60%为女性。最常见的症状:咳嗽(80%)和体温升高(63%)。23%出现肺炎。73%为双侧肺炎。年龄和男性性别与肺炎有关。20%需要住院治疗。7例患者死亡(2.9%)。基层医疗共安排了19027次新冠诊疗预约。60%的患者在基层医疗就诊时未进行胸部X光检查或未得到其他护理级别的协助。22.4%的全科医生工作日因病假缺勤。各医疗机构在胸部X光检查申请方面存在差异(最高62%,最低2%)。申请X光检查最少的基层医疗中心病假数量最多。 结论:年龄和男性性别与基层医疗中肺炎的发病有关。医疗活动强度大,各医疗机构之间存在差异。专业病假可能会影响医疗质量。
J Hosp Infect. 2020-7-21
J Assoc Physicians India. 2020-7