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《COVID 阳性患者管理路径:墨尔本公共卫生机构、初级保健与都市医院的协作》

The COVID Positive Pathway: a collaboration between public health agencies, primary care, and metropolitan hospitals in Melbourne.

机构信息

The Royal Melbourne Hospital, Melbourne, VIC.

The University of Melbourne, Melbourne, VIC.

出版信息

Med J Aust. 2022 May 2;216(8):413-419. doi: 10.5694/mja2.51449. Epub 2022 Mar 18.

Abstract

OBJECTIVES

To assess the capacity of the COVID Positive Pathway, a collaborative model of care involving the Victorian public health unit, hospital services, primary care, community organisations, and the North Western Melbourne Primary Health Network, to support people with coronavirus disease 2019 (COVID-19) isolating at home.

DESIGN, SETTING, PARTICIPANTS: Cohort study of adults in northwest Melbourne with COVID-19, 3 August - 31 December 2020.

MAIN OUTCOME MEASURES

Demographic and clinical characteristics, and social and welfare needs of people cared for in the Pathway, by care tier level.

RESULTS

Of 1392 people referred to the Pathway by the public health unit, 858 were eligible for enrolment, and 711 consented to participation; 647 (91%) remained in the Pathway until they had recovered and isolation was no longer required. A total of 575 participants (81%) received care in primary care, mostly from their usual general practitioners; 155 people (22%) received care from hospital outreach services, and 64 (9%) needed high tier care (hospitalisation). Assistance with food and other basic supplies was required by 239 people in the Pathway (34%).

CONCLUSIONS

The COVID Positive Pathway is a feasible multidisciplinary, tiered model of care for people with COVID-19. About 80% of participants could be adequately supported by primary care and community organisations, allowing hospital services to be reserved for people with more severe illness or with risk factors for disease progression. The principles of this model could be applied to other health conditions if regulatory and funding barriers to information-sharing and care delivery by health care providers can be overcome.

摘要

目的

评估 COVID 阳性通道的能力,该通道是一个涉及维多利亚公共卫生部门、医院服务、初级保健、社区组织和西北墨尔本初级保健网络的协作式护理模式,以支持在家中隔离的 2019 年冠状病毒病(COVID-19)患者。

设计、地点、参与者:2020 年 8 月 3 日至 12 月 31 日,对墨尔本西北部的 COVID-19 成年患者进行队列研究。

主要观察指标

通过护理层级,评估接受该通道护理的患者的人口统计学和临床特征以及社会和福利需求。

结果

公共卫生部门向该通道转介的 1392 人中,有 858 人符合纳入标准,有 711 人同意参与;有 647 人(91%)留在该通道,直到康复且不再需要隔离。共有 575 名参与者(81%)在初级保健机构接受护理,主要是来自其常规全科医生;155 人(22%)接受医院外展服务,64 人(9%)需要高级护理(住院治疗)。该通道中有 239 人(34%)需要食物和其他基本用品援助。

结论

COVID 阳性通道是一种可行的多学科、分层护理模式,适用于 COVID-19 患者。约 80%的参与者可以通过初级保健和社区组织得到充分支持,从而可以将医院服务保留给病情更严重或有疾病进展风险因素的患者。如果能够克服医疗服务提供者在信息共享和护理提供方面的监管和资金障碍,该模型的原则可以应用于其他健康状况。

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