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新冠疫情期间初级保健和预防保健措施的常见来源:日本全国性横断面研究

Usual source of primary care and preventive care measures in the COVID-19 pandemic: a nationwide cross-sectional study in Japan.

作者信息

Aoki Takuya, Fujinuma Yasuki, Matsushima Masato

机构信息

Division of Clinical Epidemiology, Research Center for Medical Sciences, The Jikei University School of Medicine, Tokyo, Japan

Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

出版信息

BMJ Open. 2022 Mar 16;12(3):e057418. doi: 10.1136/bmjopen-2021-057418.

Abstract

OBJECTIVES

To assess multiple preventive care measures and to examine their associations with having a usual source of primary care and primary care performance during the COVID-19 pandemic in Japan.

DESIGN

Nationwide cross-sectional study.

SETTING

Japanese general adult population.

PARTICIPANTS

1757 adult residents.

PRIMARY OUTCOME MEASURES

Fourteen preventive care measures aggregated the overall screening, immunisation and counselling composites.

RESULTS

Depression screening, zoster vaccination and tetanus vaccination had low implementation rates even among participants with a usual source of primary care. After adjustment for possible confounders, having a usual source of primary care was positively associated with all preventive care composites. Primary care performance assessed by the Japanese version of Primary Care Assessment Tool Short Form was also dose dependently associated with an increase in all composites. Results of the sensitivity analyses using a different calculation of preventive care composite were similar to those of the primary analyses.

CONCLUSIONS

Receipt of primary care, particularly high-quality primary care, contributed to increased preventive care utilisation even during the COVID-19 pandemic. However, the rate of mental health screening in primary care was at a very low level. Therefore, addressing mental health issues should be a major challenge for primary care providers during and after the pandemic.

摘要

目的

评估多项预防保健措施,并研究在日本新冠疫情期间这些措施与拥有常规初级保健来源及初级保健服务表现之间的关联。

设计

全国性横断面研究。

研究背景

日本成年普通人群。

参与者

1757名成年居民。

主要结局指标

14项预防保健措施汇总为总体筛查、免疫接种和咨询综合指标。

结果

即使在有常规初级保健来源的参与者中,抑郁症筛查、带状疱疹疫苗接种和破伤风疫苗接种的实施率也很低。在对可能的混杂因素进行调整后,拥有常规初级保健来源与所有预防保健综合指标呈正相关。由日本版初级保健评估工具简表评估的初级保健服务表现也与所有综合指标的增加呈剂量依赖性关联。使用不同计算方法的预防保健综合指标进行敏感性分析的结果与主要分析结果相似。

结论

即使在新冠疫情期间,接受初级保健,尤其是高质量的初级保健,有助于提高预防保健的利用率。然而,初级保健中的心理健康筛查率处于非常低的水平。因此,在疫情期间及之后,解决心理健康问题应是初级保健提供者面临的一项重大挑战。

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