Karaman Irem, Ildir Selin, Ozkaya Sevket
School of Medicine, Bahcesehir University, Istanbul, Turkey.
Department of Pulmonary Medicine, Faculty of Medicine, Bahcesehir University, Istanbul, Turkey.
Front Med (Lausanne). 2022 Jul 19;9:890417. doi: 10.3389/fmed.2022.890417. eCollection 2022.
The coronavirus 2019 (COVID-19) pandemic had an enormous impact on healthcare delivery globally. We conducted a cross-sectional online survey in Turkey to evaluate the impact of COVID-19 on healthcare services in Turkey. A 35-item anonymized online survey was completed by HCPs (medical doctors, MD) who continued their clinical practice during the COVID-19 pandemic in Turkey, regardless of their specialties or degrees. Overall, 209 HCPs participated in the study. Forty-two percent of the participants stated that their current workload intensity has been increased compared with the pre-pandemic era. More than half of the participants (54.6%) were using telemedicine services during their clinical practice, however, the effectiveness of telemedicine for first-time patients and follow-up patients was rated as low. The majority of participants (59.3%) reported that during the peak period of the pandemic, they encountered only a small variety of cases, other than COVID-19. Fifty-two percent of the participants agreed that they occasionally had patients who received misdiagnosis in the first admission due to the suspicion of a possible COVID-19 infection predominating the diagnostic process (eg., not excluding COVID-19 even though the PCR test is negative). For the distribution of possible late-diagnosed diseases, 25.8% of HCPs selected chest diseases, followed by infectious diseases, heart diseases, and cancer. In general, participants agreed that there was an increase in the negligence in the follow-up of various diseases and/or complication rates due to COVID-19 pandemic. Sixty percent of the HCPs agreed that HCPs are being much more rigorous to diagnose/treating COVID-19 than other important diseases. Fifty-seven percent of the participants stated that the diagnosis and follow-up of chronic diseases are affected, while 57.9% of the HCPs stated that some diseases that show similar signs and symptoms as COVID-19 are not diagnosed correctly during COVID-19 pandemic. Findings from this study emphasize that COVID-19 pandemic has significantly caused delayed diagnoses and interruption in the management of chronic diseases, and also increased the risk of missing out the diagnosis of non-COVID-19 diseases. The study genuinely aims to yield the floor to a permanent improvement in post-pandemic clinical management and it also shows the need for a focused approach in distinct areas of medical care. Policymaking is required to drive changes to better support HCPs in Turkey.
2019年冠状病毒病（COVID-19）大流行对全球医疗服务产生了巨大影响。我们在土耳其开展了一项横断面在线调查，以评估COVID-19对土耳其医疗服务的影响。在土耳其，在COVID-19大流行期间继续从事临床工作的医疗保健人员（医生，MD）完成了一项包含35个条目的匿名在线调查，无论其专业或学位如何。总体而言，209名医疗保健人员参与了该研究。42%的参与者表示，与大流行前相比，他们目前的工作量强度有所增加。超过一半的参与者（54.6%）在临床实践中使用远程医疗服务，然而，远程医疗对初诊患者和复诊患者的有效性被评为较低。大多数参与者（59.3%）报告称，在大流行高峰期，除了COVID-19之外，他们遇到的病例种类很少。52%的参与者同意，由于在诊断过程中对可能感染COVID-19的怀疑占主导地位（例如，即使PCR检测呈阴性也不排除COVID-19），他们偶尔会遇到首次入院时被误诊的患者。对于可能漏诊疾病的分布情况，25.8%的医疗保健人员选择了胸部疾病，其次是传染病、心脏病和癌症。总体而言，参与者一致认为，由于COVID-19大流行，各种疾病随访中的疏忽和/或并发症发生率有所增加。60%的医疗保健人员同意，医疗保健人员在诊断/治疗COVID-19方面比其他重要疾病更加严格。57%的参与者表示慢性病的诊断和随访受到影响，而57.9%的医疗保健人员表示，在COVID-19大流行期间，一些与COVID-19有相似体征和症状的疾病没有得到正确诊断。这项研究的结果强调，COVID-19大流行显著导致了慢性病管理的诊断延迟和中断，也增加了漏诊非COVID-19疾病的风险。该研究的真正目的是为大流行后临床管理的永久改善提供依据，同时也表明在医疗护理的不同领域需要采取有针对性的方法。需要制定政策推动变革，以更好地支持土耳其的医疗保健人员。
