Department of Primary Care and Public Health, Imperial College London, London.
Population, Policy & Practice Research Programme, UCL Great Ormond Street Institute of Child Health Population Policy and Practice, London.
Br J Gen Pract. 2022 Jun 30;72(720):e464-e471. doi: 10.3399/BJGP.2021.0643. Print 2022 Jul.
The NHS response to COVID-19 altered provision and access to primary care.
To examine the impact of COVID-19 on GP contacts with children and young people (CYP) in England.
A longitudinal trends analysis was undertaken using electronic health records from the Clinical Practice Research Datalink (CPRD) Aurum database.
All CYP aged <25 years registered with a GP in the CPRD Aurum database were included. The number of total, remote, and face-to-face contacts during the first UK lockdown (March to June 2020) were compared with the mean contacts for comparable weeks from 2015 to 2019.
In total, 47 607 765 GP contacts with 4 307 120 CYP were included. GP contacts fell 41% during the first lockdown compared with previous years. Children aged 1-14 years had greater falls in total contacts (≥50%) compared with infants and those aged 15-24 years. Face-to-face contacts fell by 88%, with the greatest falls occurring among children aged 1-14 years (>90%). Remote contacts more than doubled, increasing most in infants (over 2.5-fold). Total contacts for respiratory illnesses fell by 74% whereas contacts for common non-transmissible conditions shifted largely to remote contacts, mitigating the total fall (31%).
During the COVID-19 pandemic, CYP's contact with GPs fell, particularly for face-to-face assessments. This may be explained by a lower incidence of respiratory illnesses because of fewer social contacts and changing health-seeking behaviour. The large shift to remote contacts mitigated total falls in contacts for some age groups and for common non-transmissible conditions.
NHS 对 COVID-19 的应对改变了初级保健的服务提供和可及性。
研究 COVID-19 对英格兰全科医生(GP)看诊儿童和青少年(CYP)的影响。
使用来自临床实践研究数据链接(CPRD)Aurum 数据库的电子健康记录进行了一项纵向趋势分析。
所有年龄在 25 岁以下在 CPRD Aurum 数据库中注册的 CYP 均被纳入研究。将英国第一次封锁期间(2020 年 3 月至 6 月)的总就诊次数、远程就诊次数和面对面就诊次数与 2015 年至 2019 年同期可比周的平均就诊次数进行比较。
共纳入 47607765 名 CYP 与 4307120 名 CYP 的 47607765 次 GP 就诊记录。与往年相比,第一次封锁期间 GP 就诊次数下降了 41%。1-14 岁儿童的总就诊次数下降幅度更大(≥50%),而婴儿和 15-24 岁青少年的就诊次数则有所下降。面对面就诊次数下降了 88%,降幅最大的是 1-14 岁儿童(>90%)。远程就诊次数增加了一倍多,婴儿(增加了 2.5 倍以上)的远程就诊次数增加最多。呼吸道疾病的就诊次数下降了 74%,而常见非传染性疾病的就诊次数则主要转移到远程就诊,从而减轻了总就诊次数的下降(31%)。
在 COVID-19 大流行期间,CYP 与 GP 的接触减少,特别是面对面评估的次数减少。这可能是由于社交接触减少和改变了寻求医疗服务的行为,导致呼吸道疾病的发病率降低所致。对于一些年龄组和常见非传染性疾病,向远程就诊的大量转移缓解了总就诊次数的下降。