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2019年至2021年新冠疫情对爱尔兰全科医疗活动的影响:利用电子病历数据对50万例诊疗进行的回顾性分析

Effects of COVID-19 on Irish general practice activity from 2019 to 2021: a retrospective analysis of 500,000 consultations using electronic medical record data.

作者信息

O'Callaghan Michael E, Glynn Liam G

机构信息

School of Medicine, North Campus, University of Limerick, Limerick, Ireland.

Irish College of GPs, 4/5 Lincoln Place, Dublin 2, Ireland.

出版信息

Ir J Med Sci. 2024 Dec;193(6):2835-2841. doi: 10.1007/s11845-024-03810-6. Epub 2024 Oct 2.

Abstract

BACKGROUND

General practice (GP) is crucial to primary care delivery in the Republic of Ireland and is almost fully computerised. General practice teams were the first point of contact for much COVID-19-related care and there were concerns routine healthcare activities could be disrupted due to COVID-19 and related restrictions.

AIMS

The study aimed to assess effects of the pandemic on GP activity through analysis of electronic medical record data from general practice clinics in the Irish Midwest.

METHODS

A retrospective, descriptive study of electronic medical record data relating to patient record updates, appointments and medications prescribed across 10 GP clinics over the period 2019-2021 inclusive.

RESULTS

Data relating to 1.18 million record transactions for 32 k patients were analysed. Over 500 k appointments were examined, and demographic trends presented. Overall appointment and prescribing activity increased over the study period, while a dip was observed immediately after the pandemic's arrival in March 2020. Delivery of non-childhood immunisations increased sixfold as a result of COVID-19, childhood immunisation activity was maintained, while cervical smears decreased in 2020 as the screening programme was halted. A quarter of consultations in 2020 and 2021 were teleconsultations, and these were more commonplace for younger patients.

CONCLUSIONS

General practice responded robustly to the pandemic by taking on additional activities while maintaining routine services where possible. The shift to teleconsulting was a significant change in workflow. Analysing routinely collected electronic medical record data can provide valuable insights for service planning, and access to these insights would be beneficial for future pandemic responses.

摘要

背景

全科医疗对爱尔兰共和国的初级医疗服务至关重要,且几乎已全面实现计算机化。全科医疗团队是许多与新冠疫情相关医疗护理的首个接触点,人们担心常规医疗活动可能因新冠疫情及相关限制而受到干扰。

目的

本研究旨在通过分析爱尔兰中西部全科医疗诊所的电子病历数据,评估疫情对全科医疗活动的影响。

方法

对2019年至2021年期间10家全科医疗诊所的患者病历更新、预约及处方药物等电子病历数据进行回顾性描述性研究。

结果

分析了与3.2万名患者的118万条记录交易相关的数据。检查了超过50万个预约,并呈现了人口统计学趋势。在研究期间,总体预约和处方活动有所增加,而在2020年3月疫情到来后立即出现了下降。由于新冠疫情,非儿童免疫接种量增加了六倍,儿童免疫接种活动得以维持,而2020年宫颈涂片检查减少,因为筛查计划暂停。2020年和2021年四分之一的会诊是远程会诊,且在年轻患者中更为常见。

结论

全科医疗通过承担额外活动并尽可能维持常规服务,对疫情做出了有力回应。向远程会诊的转变是工作流程中的一项重大变化。分析常规收集的电子病历数据可为服务规划提供有价值的见解,获取这些见解将有助于未来应对疫情。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63a3/11666670/27cf5e081c50/11845_2024_3810_Fig1_HTML.jpg

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