养老院内科医生在 COVID-19 大流行第一波期间的护理：对养老院经理的回顾性调查。
General practitioner care in nursing homes during the first wave of the COVID-19 pandemic in Germany: a retrospective survey among nursing home managers.
机构信息
Institute of Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Institute of General Practice and Family Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.
出版信息
BMC Prim Care. 2022 Dec 22;23(1):334. doi: 10.1186/s12875-022-01947-w.
BACKGROUND
Though evidence on the detrimental impact of the COVID-19 pandemic in nursing homes is vast, research focusing on general practitioners' (GP) care during the pandemic in nursing homes is still scarce.
METHODS
A retrospective online survey among 1,010 nursing home managers in Germany was conducted during the first wave of the COVID-19 pandemic between November 2020 and February 2021. Associations between perceived deficits in GP care (routine and acute visits) and both general and COVID-19-related characteristics of nursing homes were analysed using multiple logistic regression analyses.
RESULTS
The majority of nursing home managers reported no deficits in GP care (routine visits, 84.3%; acute visits, 92.9%). Logistic regression analyses revealed that deficits in GP care (routine visits) were significantly associated with visiting restrictions for GPs and nursing home size. Small nursing homes (1-50 residents) were significantly more likely to report deficits in GP care (routine visits) compared to medium (51-100 residents) and large nursing homes (> 100 residents). Further, deficits in GP care (acute visits) were significantly associated with dementia as a focus of care and the burden of insufficient testing for SARS-CoV-2 among residents. Moreover, visiting restrictions for GPs were significantly associated with dementia as the focus of care and the COVID-19 incidence at the federal state level. Finally, COVID-19 cases in nursing homes were significantly associated with size of nursing homes, COVID-19-incidence on the federal state level and the burden of insufficient testing capacities for SARS-CoV-2 among residents.
CONCLUSION
We found structural factors associated with GP care deficits during the pandemic. New concepts for GP care should be implemented in pandemic preparedness plans to ensure high quality, consistent, and reliable GP care as well as effective infection prevention measures in nursing homes.
背景
尽管有大量证据表明 COVID-19 大流行对养老院造成了不利影响，但针对大流行期间全科医生（GP）在养老院护理的研究仍然很少。
方法
在 2020 年 11 月至 2021 年 2 月 COVID-19 大流行的第一波期间，对德国 1010 名养老院经理进行了回顾性在线调查。使用多逻辑回归分析，分析了 GP 护理（常规和急性就诊）感知缺陷与养老院的一般和 COVID-19 相关特征之间的关联。
结果
大多数养老院经理报告 GP 护理（常规就诊）没有缺陷（84.3%；急性就诊 92.9%）。逻辑回归分析显示，GP 护理（常规就诊）的缺陷与 GP 的就诊限制和养老院规模显著相关。小型养老院（1-50 名居民）与中型（51-100 名居民）和大型养老院（>100 名居民）相比，报告 GP 护理（常规就诊）缺陷的可能性显著更高。此外，GP 护理（急性就诊）的缺陷与护理重点为痴呆症以及居民中 SARS-CoV-2 检测不足的负担显著相关。此外，GP 的就诊限制与痴呆症作为护理重点以及州级 COVID-19 发病率显著相关。最后，养老院的 COVID-19 病例与养老院的规模、州级 COVID-19 发病率以及居民中 SARS-CoV-2 检测能力不足的负担显著相关。
结论
我们发现了与大流行期间 GP 护理缺陷相关的结构性因素。在大流行准备计划中应实施新的 GP 护理概念，以确保高质量、一致和可靠的 GP 护理以及养老院的有效感染预防措施。
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