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[Primary Care Strategies and Cooperation During the First Phase of the COVID-19 Pandemic in Baden-Wuerttemberg, Germany].[德国巴登-符腾堡州新冠疫情第一阶段的初级保健策略与合作]
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[2020年新冠疫情早期巴伐利亚州门诊护理区域医疗协调员的经验:区域门诊协调员和全科医生调查]

[Experiences with Regional Medical Coordinators in Ambulatory Care in the Early COVID-19 Phase 2020 in Bavaria: Survey of Regional Ambulatory Coordinators and General Practitioners].

作者信息

Olm Michaela, Schymura Jens Boris, Torge Marion, Riedl Bernhard, Wapler Peter, Wartner Anton, Vorderwülbecke Florian, Schneider Antonius, Linde Klaus

机构信息

Institut für Allgemeinmedizin und Versorgungsforschung, Technische Universität München Fakultät für Medizin, München, Germany.

出版信息

Gesundheitswesen. 2022 Feb;84(2):97-106. doi: 10.1055/a-1719-1072. Epub 2022 Feb 15.

DOI:10.1055/a-1719-1072
PMID:35168286
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11248550/
Abstract

BACKGROUND

During the state of emergency in Bavaria in the early Corona phase 2020, some physicians in ambulatory care were appointed as regional medical coordinators (RMCs). The aim of the present study was to evaluate this newly introduced but temporary position.

METHODS

In November 2020, a paper-based questionnaire was sent out to all 85 RMCs who could be identified through an internet research and to all 197 teaching practices of the Institute of General Practice and Health Services Research at the Technical University of Munich. The data analysis was descriptive and anonymised.

RESULTS

Overall, 75 (88%) RMCs and 156 (79%) general practitioners (GPs) were included. 97% of the RMCs and 67% of the GPs assessed the introduction of RMCs in ambulatory care as reasonable, but also as an intervention concerning the self-administration of physicians (RMCs: 59% and GPs: 42%). 37% of the GPs stated that RMCs should be avoided as far as possible in future pandemic situations. Overall, GPs with more intensive contact to an RMC showed higher levels of agreement. Both groups rated the collaboration and communication strategies of politics, authorities and the Bavarian Association of Statutory Health Insurance Physicians as difficult and often contradictory. However, most of the RMCs assessed the cooperation with politics and authorities at the local level as positive. The lack of medical protective equipment at the beginning of the pandemic was judged critically by both groups of the respondents.

CONCLUSIONS

The establishment of RMCs in the early Corona phase 2020 in Bavaria was considered sensible by almost all RMCs and the majority of the surveyed GPs. For the future, it seems necessary to involve primary care physicians more intensively and permanently in decision-making processes and to strengthen existing structures.

摘要

背景

在2020年新冠疫情初期巴伐利亚州的紧急状态期间,一些门诊护理医生被任命为地区医疗协调员(RMC)。本研究的目的是评估这一最新设立但为临时性质的职位。

方法

2020年11月,向通过网络搜索能够识别的所有85名RMC以及慕尼黑工业大学全科医学与卫生服务研究所的所有197家教学诊所发放了纸质问卷。数据分析采用描述性方法且进行了匿名处理。

结果

总体而言,纳入了75名(88%)RMC和156名(79%)全科医生(GP)。97%的RMC和67%的GP认为在门诊护理中引入RMC是合理的,但也认为这是对医生自我管理的一种干预(RMC:59%,GP:42%)。37%的GP表示在未来大流行情况下应尽可能避免设立RMC。总体而言,与RMC接触更频繁的GP表示同意的程度更高。两组都认为政治部门、当局以及巴伐利亚法定医疗保险医生协会的协作和沟通策略困难且往往相互矛盾。然而,大多数RMC对与地方层面的政治部门和当局的合作给予积极评价。两组受访者都对疫情初期医疗防护设备的短缺做出了严厉评判。

结论

2020年新冠疫情初期在巴伐利亚设立RMC几乎得到了所有RMC以及大多数受访GP的认可。未来,似乎有必要让基层医疗医生更深入、更持久地参与决策过程,并加强现有结构。