Bourgueil Yann, Breton Mylaine, Cohidon Christine, Hudon Catherine, Senn Nicolas, Van Durme Thérèse
Sante Publique. 2022;33(6):991-995. doi: 10.3917/spub.216.0991.
Facing COVID-19, most of health care system first responded with the confinement of the population and an increase of intensive care resources. Primary care was then mobilized variably and more or less coordinated.
Comparing the involvement of primary care in four francophone regions with similar primary care to draw lessons for reforms directions in light of the COVID experience.
Mobilization of primary care actors was important, heterogeneous and linked to local context and previous dynamics at the territorial level or the practice level except in Quebec where primary care is governed by health authorities. The creation of COVID centers was systematic as "warm practices" in Quebec or left to the initiative of local stakeholders more or less supported by health authorities. Teleconsultation, largely dominated by the use of the telephone, was implemented everywhere, generally supported by flexible and adapted pricing. The performance of diagnostic tests such as vaccination by new professionals within a legal, financial and simple training framework is a major area for improvement. Information systems to assess local needs were insufficient everywhere.
The definition of primary care governance methods and, in particular, the link between professionals and public health operators in the four areas studied is a priority area for improvement at both local and national levels.
面对新冠疫情，大多数医疗系统首先采取的应对措施是限制人员流动并增加重症监护资源。随后，基层医疗以不同方式被调动起来，且协调程度不一。
比较四个法语地区基层医疗的参与情况，这些地区的基层医疗情况相似，以便根据新冠疫情的经验为改革方向吸取教训。
基层医疗行动者的动员很重要，但情况各异，且与当地情况以及地区或实践层面先前的动态相关，魁北克除外，在魁北克基层医疗由卫生当局管理。新冠中心的设立是系统性的，在魁北克是作为“温馨诊所”，或在卫生当局或多或少的支持下由当地利益相关者自行发起。远程会诊在各地都有实施，主要以电话使用为主，通常有灵活且适用的定价支持。在合法、财务和简单的培训框架内，由新专业人员进行疫苗接种等诊断测试的表现是一个主要的改进领域。各地评估当地需求的信息系统都不足。
在所研究的四个地区，基层医疗管理方法的定义，尤其是专业人员与公共卫生工作者之间的联系，是地方和国家层面都需优先改进的领域。
