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30 个欧洲国家初级卫生保健中 COVID-19 患者的临床路径:Eurodata 研究。

Clinical pathway of COVID-19 patients in primary health care in 30 European countries: Eurodata study.

机构信息

Federica Montseny Health Centre, Gerencia Asistencial Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain.

Medical Specialties and Public Health, School of Health Sciences, University Rey Juan Carlos, Madrid, Spain.

出版信息

Eur J Gen Pract. 2023 Dec;29(2):2182879. doi: 10.1080/13814788.2023.2182879. Epub 2023 Mar 21.

Abstract

BACKGROUND

Most COVID-19 patients were treated in primary health care (PHC) in Europe.

OBJECTIVES

To demonstrate the scope of PHC workflow during the COVID-19 pandemic emphasising similarities and differences of patient's clinical pathways in Europe.

METHODS

Descriptive, cross-sectional study with data acquired through a semi-structured questionnaire in PHC in 30 European countries, created ad hoc and agreed upon among all researchers who participated in the study. GPs from each country answered the approved questionnaire. Main variable: PHC COVID-19 acute clinical pathway. All variables were collected from each country as of September 2020.

RESULTS

COVID-19 clinics in PHC facilities were organised in 8/30. Case detection and testing were performed in PHC in 27/30 countries. RT-PCR and lateral flow tests were performed in PHC in 23/30, free of charge with a medical prescription. Contact tracing was performed mainly by public health authorities. Mandatory isolation ranged from 5 to 14 days. Sick leave certification was given exclusively by GPs in 21/30 countries. Patient hotels or other resources to isolate patients were available in 12/30. Follow-up to monitor the symptoms and/or new complementary tests was made mainly by phone call (27/30). Chest X-ray and phlebotomy were performed in PHC in 18/30 and 23/30 countries, respectively. Oxygen and low-molecular-weight heparin were available in PHC (21/30).

CONCLUSION

In Europe PHC participated in many steps to diagnose, treat and monitor COVID-19 patients. Differences among countries might be addressed at European level for the management of future pandemics.

摘要

背景

大多数 COVID-19 患者在欧洲的初级保健(PHC)中接受治疗。

目的

展示 COVID-19 大流行期间 PHC 工作流程的范围,强调欧洲患者临床路径的相似之处和差异。

方法

这是一项描述性的、横断面研究,数据来自 30 个欧洲国家的 PHC ,通过半结构化问卷获得,该问卷由参与研究的所有研究人员共同制定和商定。每个国家的全科医生回答了经过批准的问卷。主要变量:PHC COVID-19 急性临床路径。所有变量均于 2020 年 9 月从每个国家收集。

结果

8/30 的 PHC 设施组织了 COVID-19 诊所。27/30 个国家在 PHC 中进行了病例发现和检测。23/30 个国家在 PHC 中进行了 RT-PCR 和侧向流动检测,凭医疗处方免费进行。接触者追踪主要由公共卫生当局进行。强制性隔离时间从 5 天到 14 天不等。病假证明仅由 21/30 个国家的全科医生发放。12/30 个国家提供了供患者隔离的酒店或其他资源。27/30 个国家主要通过电话进行随访以监测症状和/或新的补充检查。18/30 和 23/30 个国家分别在 PHC 中进行了胸部 X 光检查和静脉采血。21/30 个国家的 PHC 中提供了氧气和低分子量肝素。

结论

在欧洲,PHC 参与了诊断、治疗和监测 COVID-19 患者的许多步骤。未来大流行管理方面的差异可能在欧洲层面得到解决。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5854/10324993/74e3bbcbb266/IGEN_A_2182879_F0001_C.jpg

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