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新冠疫情后基层医疗团队的重组。PRICOV研究中加泰罗尼亚与西班牙的差异。

Primary care team reorganisation after the SARS-COV-2 pandemic. Differences between Catalonia and Spain in the PRICOV study.

作者信息

Peris Grao Antoni, Freixenet Núria, Mora Toni, Roche David

机构信息

Castelldefels Agents de Salut (CASAP), Castelldefels, Spain.

Research Institute for Evaluation and Public Policies (IRAPP), Universitat Internacional de Catalunya, Barcelona, Spain.

出版信息

Health Serv Manage Res. 2025 Feb;38(1):31-36. doi: 10.1177/09514848241265784. Epub 2024 Jul 21.

Abstract

BACKGROUND

Spanish primary care services are managed differently by each region's authorities. Catalonia started its services provision and design nearly two decades before other Spanish regions and developed nurses' roles and task shifting in primary care.

PURPOSE

This work identifies differences in the Europe PRICOV-19 study answers between Catalonia and those submitted from the rest of Spain regarding how primary care teams (PCT) were organised during the SARS-CoV-2-2019 pandemic, how tasks and roles changed, and the pandemic's impact on the care providers. Initially, we computed bivariate relationships and tested using contingency association and unpaired Wilcoxon.

ANALYSIS

Still, we estimated multiple linear regressions controlling with a list of individual and GP practice characteristics and clustering standard errors at the kind of location.

RESULTS

Main statistically significant differences were found in the adaptation to the new tasks, the ability to solve most health problems, and specific accessibilities to primary care. In Catalonia, satisfaction with the adaptation to the new tasks was higher (41.9% satisfied and 30.2% neutral) than in the rest of Spain (50.9% dissatisfaction). Also, GPs in Catalonia reported to a greater extent than the rest of Spain that chronic patients were listed for extensive follow-up. These differences may be related to Catalonia's strategy for empowering primary care professionals other than family doctors.

CONCLUSIONS

Considering future pandemics, demographic ageing, and professional shortages, we point out the potential benefits of these changes in PCT organisations and the need to review the centres's design.

摘要

背景

西班牙各地区当局对初级保健服务的管理方式不同。加泰罗尼亚在其他西班牙地区近二十年前就开始提供和设计其服务,并在初级保健中发展了护士的角色和任务转移。

目的

这项工作确定了加泰罗尼亚与西班牙其他地区在欧洲PRICOV-19研究答案中的差异,这些差异涉及在2019年冠状病毒病大流行期间初级保健团队(PCT)的组织方式、任务和角色如何变化以及大流行对护理提供者的影响。最初,我们计算了双变量关系,并使用列联关联和未配对威尔科克森检验进行了测试。

分析

尽管如此,我们估计了多元线性回归,控制了一系列个人和全科医生执业特征,并在地点类型上对标准误差进行了聚类。

结果

在适应新任务、解决大多数健康问题的能力以及初级保健的特定可及性方面发现了主要的统计学显著差异。在加泰罗尼亚,对适应新任务的满意度更高(41.9%满意,30.2%中立),高于西班牙其他地区(50.9%不满意)。此外,加泰罗尼亚的全科医生比西班牙其他地区更广泛地报告称,慢性病患者被列入了广泛随访名单。这些差异可能与加泰罗尼亚赋予家庭医生以外的初级保健专业人员权力的战略有关。

结论

考虑到未来的大流行、人口老龄化和专业人员短缺,我们指出了这些PCT组织变革的潜在好处以及审查中心设计的必要性。

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