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COVID-19 大流行对初级保健就诊的影响:国际初级保健大数据研究联合会(INTRePID)的国际比较研究。

Changes in primary care visits arising from the COVID-19 pandemic: an international comparative study by the International Consortium of Primary Care Big Data Researchers (INTRePID).

机构信息

Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada

Departments of Research and Innovation and Family Medicine-North York General Hospital, Toronto Western Family Health Team-University Health Network, Toronto, Ontario, Canada.

出版信息

BMJ Open. 2022 May 9;12(5):e059130. doi: 10.1136/bmjopen-2021-059130.


DOI:10.1136/bmjopen-2021-059130
PMID:35534063
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9086267/
Abstract

INTRODUCTION: Through the ernational Consotium of rimary Care Bg ata Researchers (), we compared the pandemic impact on the volume of primary care visits and uptake of virtual care in Australia, Canada, China, Norway, Singapore, South Korea, Sweden, the UK and the USA. METHODS: Visit definitions were agreed on centrally, implemented locally across the various settings in INTRePID countries, and weekly visit counts were shared centrally for analysis. We evaluated the weekly rate of primary care physician visits during 2019 and 2020. Rate ratios (RRs) of total weekly visit volume and the proportion of weekly visits that were virtual in the pandemic period in 2020 compared with the same prepandemic period in 2019 were calculated. RESULTS: In 2019 and 2020, there were 80 889 386 primary care physician visits across INTRePID. During the pandemic, average weekly visit volume dropped in China, Singapore, South Korea, and the USA but was stable overall in Australia (RR 0.98 (95% CI 0.92 to 1.05, p=0.59)), Canada (RR 0.96 (95% CI 0.89 to 1.03, p=0.24)), Norway (RR 1.01 (95% CI 0.88 to 1.17, p=0.85)), Sweden (RR 0.91 (95% CI 0.79 to 1.06, p=0.22)) and the UK (RR 0.86 (95% CI 0.72 to 1.03, p=0.11)). In countries that had negligible virtual care prepandemic, the proportion of visits that were virtual were highest in Canada (77.0%) and Australia (41.8%). In Norway (RR 8.23 (95% CI 5.30 to 12.78, p<0.001), the UK (RR 2.36 (95% CI 2.24 to 2.50, p<0.001)) and Sweden (RR 1.33 (95% CI 1.17 to 1.50, p<0.001)) where virtual visits existed prepandemic, it increased significantly during the pandemic. CONCLUSIONS: The drop in primary care in-person visits during the pandemic was a global phenomenon across INTRePID countries. In several countries, primary care shifted to virtual visits mitigating the drop in in-person visits.

摘要

简介:通过初级保健国际研究联合会(INTRePID),我们比较了澳大利亚、加拿大、中国、挪威、新加坡、韩国、瑞典、英国和美国的大流行对初级保健就诊量和虚拟保健采用量的影响。

方法:集中商定就诊定义,在 INTRePID 国家的各种环境中在当地实施,并集中共享每周就诊计数进行分析。我们评估了 2019 年和 2020 年每周初级保健医生就诊率。计算了 2020 年大流行期间每周总就诊量的比率比(RR)和每周虚拟就诊量占比,与 2019 年同一大流行前同期相比。

结果:在 2019 年和 2020 年期间,INTRePID 共进行了 80889386 次初级保健医生就诊。在大流行期间,中国、新加坡、韩国和美国的平均每周就诊量下降,但澳大利亚(RR0.98(95%CI0.92 至 1.05,p=0.59))、加拿大(RR0.96(95%CI0.89 至 1.03,p=0.24))、挪威(RR1.01(95%CI0.88 至 1.17,p=0.85))、瑞典(RR0.91(95%CI0.79 至 1.06,p=0.22))和英国(RR0.86(95%CI0.72 至 1.03,p=0.11))的总体就诊量保持稳定。在大流行前虚拟保健服务可忽略不计的国家中,加拿大(77.0%)和澳大利亚(41.8%)的就诊虚拟比例最高。挪威(RR8.23(95%CI5.30 至 12.78,p<0.001))、英国(RR2.36(95%CI2.24 至 2.50,p<0.001))和瑞典(RR1.33(95%CI1.17 至 1.50,p<0.001))在大流行前已经存在虚拟就诊,在大流行期间这一比例显著增加。

结论:大流行期间初级保健现场就诊量的下降是 INTRePID 国家的全球现象。在几个国家,初级保健转向虚拟就诊,从而减轻了现场就诊量的下降。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e0e/9086267/9429fcfe4085/bmjopen-2021-059130f02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e0e/9086267/62788f2146ea/bmjopen-2021-059130f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e0e/9086267/9429fcfe4085/bmjopen-2021-059130f02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e0e/9086267/62788f2146ea/bmjopen-2021-059130f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e0e/9086267/9429fcfe4085/bmjopen-2021-059130f02.jpg

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