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COVID-19 期间初级保健实践中慢性疾病患者的随访:来自 PRICOV-19 研究的 7 个中东欧国家的横断面研究结果。

Follow-up of patients with chronic conditions within primary care practices during COVID-19: Results from 7 Central and Eastern-European countries from the cross-sectional PRICOV-19 study.

机构信息

Swiss Tropical and Public Health Institute, Allschwil, Switzerland.

University of Basel, Basel, Switzerland.

出版信息

Eur J Gen Pract. 2024 Dec;30(1):2391468. doi: 10.1080/13814788.2024.2391468. Epub 2024 Aug 29.

DOI:10.1080/13814788.2024.2391468
PMID:39207040
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11363735/
Abstract

BACKGROUND

The COVID-19 pandemic posed severe challenges to delivery of services at Primary Care level and for achieving follow-up of patients with chronic diseases.

OBJECTIVES

We analysed data from the PRICOV-19 study to explore determinants of active follow-up for chronic disease patients in seven Central and Eastern European (CEE) countries during the pandemic.

METHODS

Pricov-19 was a cross-sectional study conducted within PC (Primary Care) practices in 37 European countries. We analysed data from 7 CEE countries (Bulgaria, Czech Republic, Hungary, Poland, Moldova, Romania, Ukraine) collected between November 2020 and December 2021. Practices were recruited through random or convenience sampling and participation of practices was voluntary. We performed descriptive statistics to identify the level of follow-up of chronic disease and what health system and practice-specific factors were associated with better follow-up. We used logistic regression and meta-analysis techniques to explore associations and heterogeneity between countries.

RESULTS

67.8% out of 978 practices reported actively following up chronic patients. Positive associations were found between active follow-up and such as having more GPs (aOR = 1.18, p-value = 0.005), an above-average chronic patient population (aOR = 3.13, p-value = 0.006), adequate government support (aOR = 2.35, p-value = 0.001), and GPs having time for guideline reading (aOR = 0.008, p-value = 1.71).

CONCLUSIONS

Patient follow-up, was influenced by different health system and practice-specific factors. The implications suggest the need for government support to enhance PC practice organisation during crises and solutions to decrease GP workload and provide tailored care for patients with chronic disease.

摘要

背景

COVID-19 大流行对初级保健服务的提供以及慢性病患者的随访带来了严峻挑战。

目的

我们分析了 PRICOV-19 研究的数据,以探讨在大流行期间七个中东欧(CEE)国家慢性病患者主动随访的决定因素。

方法

Pricov-19 是一项在 37 个欧洲国家的初级保健(PC)实践中进行的横断面研究。我们分析了 2020 年 11 月至 2021 年 12 月期间来自 7 个 CEE 国家(保加利亚、捷克共和国、匈牙利、波兰、摩尔多瓦、罗马尼亚、乌克兰)的数据。通过随机或便利抽样招募实践,实践的参与是自愿的。我们进行了描述性统计,以确定慢性病的随访水平以及哪些卫生系统和实践特定因素与更好的随访相关。我们使用逻辑回归和荟萃分析技术来探索国家之间的关联和异质性。

结果

978 家实践中有 67.8%报告积极随访慢性病患者。积极随访与以下因素呈正相关:有更多的全科医生(优势比(aOR)=1.18,p 值=0.005)、高于平均水平的慢性病患者人群(aOR = 3.13,p 值=0.006)、政府的充分支持(aOR = 2.35,p 值=0.001),以及全科医生有时间阅读指南(aOR = 0.008,p 值=1.71)。

结论

患者随访受到不同卫生系统和实践特定因素的影响。这表明在危机期间需要政府支持来加强 PC 实践组织,并找到解决方案来减轻全科医生的工作量,为慢性病患者提供量身定制的护理。

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