Centers for Disease Control and Prevention, COVID-19 Emergency Response, Atlanta, GA, United States.
General Dynamics Information Technology, Falls Church, VA, United States.
J Med Internet Res. 2023 Mar 10;25:e39054. doi: 10.2196/39054.
In 2020, at the onset of the COVID-19 pandemic, the United States experienced surges in healthcare needs, which challenged capacity throughout the healthcare system. Stay-at-home orders in many jurisdictions, cancellation of elective procedures, and closures of outpatient medical offices disrupted patient access to care. To inform symptomatic persons about when to seek care and potentially help alleviate the burden on the healthcare system, Centers for Disease Control and Prevention (CDC) and partners developed the CDC Coronavirus Self-Checker ("Self-Checker"). This interactive tool assists individuals seeking information about COVID-19 to determine the appropriate level of care by asking demographic, clinical, and nonclinical questions during an online "conversation."
This paper describes user characteristics, trends in use, and recommendations delivered by the Self-Checker between March 23, 2020, and April 19, 2021, for pursuing appropriate levels of medical care depending on the severity of user symptoms.
User characteristics and trends in completed conversations that resulted in a care message were analyzed. Care messages delivered by the Self-Checker were manually classified into three overarching conversation themes: (1) seek care immediately; (2) take no action, or stay home and self-monitor; and (3) conversation redirected. Trends in 7-day averages of conversations and COVID-19 cases were examined with development and marketing milestones that potentially impacted Self-Checker user engagement.
Among 16,718,667 completed conversations, the Self-Checker delivered recommendations for 69.27% (n=11,580,738) of all conversations to "take no action, or stay home and self-monitor"; 28.8% (n=4,822,138) of conversations to "seek care immediately"; and 1.89% (n=315,791) of conversations were redirected to other resources without providing any care advice. Among 6.8 million conversations initiated for self-reported sick individuals without life-threatening symptoms, 59.21% resulted in a recommendation to "take no action, or stay home and self-monitor." Nearly all individuals (99.8%) who were not sick were also advised to "take no action, or stay home and self-monitor."
The majority of Self-Checker conversations resulted in advice to take no action, or stay home and self-monitor. This guidance may have reduced patient volume on the medical system; however, future studies evaluating patients' satisfaction, intention to follow the care advice received, course of action, and care modality pursued could clarify the impact of the Self-Checker and similar tools during future public health emergencies.
2020 年，在 COVID-19 大流行开始时，美国的医疗需求激增，这对整个医疗系统的能力构成了挑战。许多司法管辖区的居家令、选择性手术的取消以及门诊医疗办公室的关闭，打乱了患者获得护理的机会。为了告知有症状的人何时寻求护理，并有可能帮助减轻医疗系统的负担，疾病控制与预防中心 (CDC) 和合作伙伴开发了 CDC 冠状病毒自我检查器（“自我检查器”）。这个互动工具通过在在线“对话”中询问人口统计学、临床和非临床问题，帮助寻求 COVID-19 信息的个人确定适当的护理水平。
本研究描述了 2020 年 3 月 23 日至 2021 年 4 月 19 日期间，根据用户症状严重程度，自我检查器在建议采取适当医疗护理水平方面的用户特征、使用趋势和推荐情况。
分析了完成对话的用户特征和趋势，这些对话导致了护理信息。自我检查器提供的护理信息由人工分为三个总体对话主题进行分类：（1）立即寻求护理；（2）无需采取行动，或留在家中并自我监测；（3）对话重定向。通过可能影响自我检查器用户参与度的开发和营销里程碑，研究了 7 天平均对话量和 COVID-19 病例的趋势。
在 16718667 次完成的对话中，自我检查器为 69.27%（n=11580738）的所有对话提供了建议，即“无需采取行动，或留在家中并自我监测”；28.8%（n=4822138）的对话建议“立即寻求护理”；1.89%（n=315791）的对话被重新定向到其他资源，而没有提供任何护理建议。在为自我报告有症状但无生命威胁的个体发起的 680 万次对话中，59.21%的对话建议“无需采取行动，或留在家中并自我监测”。几乎所有未生病的个体（99.8%）也被建议“无需采取行动，或留在家中并自我监测”。
大多数自我检查器对话的结果是建议无需采取行动，或留在家中并自我监测。这一指导可能减少了医疗系统的患者量；然而，未来评估患者满意度、遵循所收到护理建议的意愿、行动过程和所寻求的护理模式的研究，可以阐明自我检查器和类似工具在未来公共卫生紧急事件中的影响。
