斯洛文尼亚家庭医学中新冠疫情期间患者管理的安全性：一项横断面研究。

The safety of patient management in family medicine in Slovenia during Covid-19: a cross-sectional study.

机构信息

Department of Family Medicine, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.

Department of Family Medicine, Medical Faculty, University of Maribor, Maribor, Slovenia.

出版信息

BMC Prim Care. 2023 Nov 29;24(Suppl 1):255. doi: 10.1186/s12875-023-02209-z.

DOI:10.1186/s12875-023-02209-z

PMID:38031008

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10687777/

Abstract

BACKGROUND

During the Covid-19 pandemic, family medicine practices (FMPs) changed to improve safety against new coronavirus infections for both patients and employees. Protocols for treating patients with suspected Sars-Cov-2 infections were established to protect medical staff and other patients from being infected. However, these protocols also led to increased safety risks, such as delays in treating patients with other medical conditions. This exploratory study aimed to investigate safety risks in treating patients in FMPs during the Covid-19 pandemic and to suggest improvements to prevent Covid-19 in FMPs in Slovenia.

METHODS

A cross-sectional study was rolled out in FMPs in Slovenia as part of the international Pricov-19 study. Data collection on safety management during the Covid-19 pandemic in FMPs in Slovenia took place from November 2020 until January 2021 using a self-administered online survey for FP working in Slovenia. A chi-square test, ANOVA, independent samples t-test or bivariate correlation test was performed to explore associations regarding the safety of patients' management variables.

RESULTS

From the 191 participating family physicians (FPs) (15.2% response rate), 54.8% reported having treated patients with fever (not Covid-19) late due to the new protocols at least once, and 54.8% reported patients with urgent conditions having been seen late at least once due to not coming. In the suburbs and rural environments FPs more often reported that at least once patient with a fever (not Covid-19) was seen late due to the protocol (p = 0.017) and more often reported that at least once patient with an urgent condition was seen late due to not coming to their FP (p = 0.017). The larger the practice, the more they reported that at least once a patient with fever (not Covid-19) was seen late due to the protocol (p = 0.012) and the more they reported at least once a patient with an urgent condition was seen late due to not coming to their FP (p = 0.012).

CONCLUSION

Covid-19 affected the safety of patient management in FMP in Slovenia. The most common problem was foregone care. Therefor, protocols for chronic patient management in the event of epidemics need to be established.

摘要

背景

在新冠疫情期间，家庭医学实践（FMP）为了提高患者和员工对新型冠状病毒感染的安全性而改变。制定了治疗疑似 Sars-Cov-2 感染患者的方案，以保护医务人员和其他患者免受感染。然而，这些方案也导致了安全风险的增加，例如延迟治疗其他医疗条件的患者。这项探索性研究旨在调查新冠疫情期间 FMP 治疗患者的安全风险，并提出改善斯洛文尼亚 FMP 新冠防控的建议。

方法

作为 Pricov-19 国际研究的一部分，在斯洛文尼亚的 FMP 中开展了一项横断面研究。2020 年 11 月至 2021 年 1 月，通过斯洛文尼亚家庭医生的在线自我管理调查，收集新冠疫情期间 FMP 安全管理数据。使用卡方检验、方差分析、独立样本 t 检验或双变量相关检验来探讨与患者管理变量安全相关的关联。

结果

在 191 名参与的家庭医生（FP）中（15.2%的回复率），54.8%报告因新方案至少一次延迟治疗发热（非新冠）患者，54.8%报告至少一次因未就诊而延迟治疗紧急情况患者。在郊区和农村环境中，FPs 更经常报告因方案至少一次延迟治疗发热（非新冠）患者（p=0.017），更经常报告因未就诊而至少一次延迟治疗紧急情况患者（p=0.017）。实践规模越大，因方案至少一次延迟治疗发热（非新冠）患者的报告越多（p=0.012），因未就诊而至少一次延迟治疗紧急情况患者的报告也越多（p=0.012）。