2019冠状病毒病大流行开始后基层医疗就诊原因的变化：基层医疗大数据研究国际联盟（INTRePID）的一项国际比较研究
Changes in reasons for visits to primary care after the start of the COVID-19 pandemic: An international comparative study by the International Consortium of Primary Care Big Data Researchers (INTRePID).
作者信息
Tu Karen, Lapadula María C, Apajee Jemisha, Bonilla Angela Ortigoza, Baste Valborg, Cuba-Fuentes María S, de Lusignan Simon, Flottorp Signe, Gaona Gabriela, Goh Lay Hoon, Hallinan Christine M, Kristiansson Robert S, Laughlin Adrian, Li Zhuo, Ling Zheng J, Manski-Nankervis Jo-Anne, Ng Amy P P, Scattini Luciano F, Silva-Valencia Javier, Pace Wilson D, Wensaas Knut-Arne, Wong William C W, Zingoni Paula L, Westfall John M
机构信息
Department of Family and Community Medicine, University of Toronto, Toronto, Canada.
North York General Hospital, Toronto, Canada.
出版信息
PLOS Glob Public Health. 2024 Aug 22;4(8):e0003406. doi: 10.1371/journal.pgph.0003406. eCollection 2024.
BACKGROUND
The COVID-19 pandemic has reshaped healthcare delivery worldwide.
OBJECTIVE
To explore potential changes in the reasons for visits and modality of care in primary care settings through the International Consortium of Primary Care Big Data Researchers (INTRePID).
METHODS
We conducted a cross-sectional, retrospective study from 2018-2021. We examined visit volume, modality, and reasons for visits to primary care in Argentina, Australia, Canada, China, Peru, Norway, Singapore, Sweden, and the USA. The analysis involved a comparison between the pre-pandemic and pandemic periods.
RESULTS
There were more than 215 million visits from over 38 million patients during the study period in INTRePID primary care settings. Most INTRePID countries experienced a decline in monthly visit rates during the first year of the pandemic, with rate ratios (RR) and 95% confidence intervals (CI) ranging from RR:0.57 (95%CI:0.49-0.66) to RR:0.90 (95%CI:0.83-0.98), except for in Canada (RR:0.99, 95%CI:0.94-1.05) and Norway (RR:1.00, 95%CI:0.92-1.10), where rates remained stable and in Australia where rates increased (RR:1.19, 95%CI:1.11-1.28). Argentina, China, and Singapore had limited or no adoption of virtual care, whereas the remaining INTRePID countries varied in the extent of virtual care utilization. In Peru, virtual visits accounted for 7.34% (95%CI:7.33%-7.35%) of all interactions in the initial year of the pandemic, dipping to 5.22% (95%CI:5.21%-5.23%) in the subsequent year. However, in Canada 75.30% (95%CI:75.20%-75.40%) of the visits in the first year were virtual, decreasing to 62.77% (95%CI:62.66%-62.88%) in the second year. Diabetes, hypertension and/or hyperlipidemia and general health exams were in the top 10 reasons for visits in 2019 for all countries. Anxiety, depression and/or other mental health related reasons were among the top 10 reasons for virtual visits in all countries that had virtual care.
CONCLUSIONS
The pandemic resulted in changes in reasons for visits to primary care, with virtual care mitigating visit volume disruptions in many countries.
背景
新冠疫情重塑了全球的医疗服务模式。
目的
通过国际初级保健大数据研究联盟（INTRePID），探讨初级保健机构就诊原因和护理方式的潜在变化。
方法
我们进行了一项2018 - 2021年的横断面回顾性研究。我们考察了阿根廷、澳大利亚、加拿大、中国、秘鲁、挪威、新加坡、瑞典和美国初级保健机构的就诊量、护理方式及就诊原因。分析涉及疫情前和疫情期间的对比。
结果
在INTRePID初级保健机构的研究期间，超过3800万患者进行了超过2.15亿次就诊。大多数INTRePID国家在疫情的第一年每月就诊率下降，率比（RR）和95%置信区间（CI）范围从RR：0.57（95%CI：0.49 - 0.66）到RR：0.90（95%CI：0.83 - 0.98），加拿大（RR：0.99，95%CI：0.94 - 1.05）和挪威（RR：1.00，95%CI：0.92 - 1.10）除外，这两个国家就诊率保持稳定，澳大利亚就诊率上升（RR：1.19，95%CI：1.11 - 1.28）。阿根廷、中国和新加坡很少或没有采用虚拟护理，而其他INTRePID国家在虚拟护理的使用程度上有所不同。在秘鲁，疫情第一年虚拟就诊占所有互动的7.34%（95%CI：7.33% - 7.35%），次年降至5.22%（95%CI：5.21% - 5.23%）。然而，在加拿大，第一年75.30%（95%CI：75.20% - 75.40%）的就诊是虚拟就诊，次年降至62.77%（95%CI：62.66% - 62.88%）。糖尿病、高血压和/或高脂血症以及一般健康检查是2019年所有国家就诊的前十大原因。焦虑、抑郁和/或其他心理健康相关原因是所有提供虚拟护理国家虚拟就诊的前十大原因。
结论
疫情导致初级保健就诊原因发生变化，虚拟护理在许多国家缓解了就诊量的中断。
Zotero 插件