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2019年冠状病毒病大流行限制措施对患有常见及高危诊断疾病患者与全科医生接触的影响:一项基于挪威登记处的研究

The impact of COVID-19 pandemic restrictions on general practitioner contacts among patients with common and at-risk diagnoses: a Norwegian registry-based study.

作者信息

Dale Jonas Nordvik, Morken Tone, Eliassen Knut Eirik, Blinkenberg Jesper, Rortveit Guri, Baste Valborg

机构信息

National Centre for Emergency Primary Health Care, NORCE Norwegian Research Centre, Bergen, Norway.

Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.

出版信息

Scand J Prim Health Care. 2025 Sep;43(3):660-671. doi: 10.1080/02813432.2025.2491762. Epub 2025 Apr 21.


DOI:10.1080/02813432.2025.2491762
PMID:40259512
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12377136/
Abstract

BACKGROUND: Disease prevention strategies during the COVID-19 pandemic could potentially disrupt the continuity of care. Aims: (1) describe changes in contacts with general practitioner (GP) before and during the pandemic, (2) compare consultation rates for common and at-risk diagnoses, and (3) examine the impact of COVID-19 restrictions on monthly consultation rates across patient subgroups. METHODS: Register study with data from the Norwegian Registry for Primary Health Care (NRPHC) for the period 1 April 2018 to 30 March 2021. Changes in consultation rate were the main outcome. Twenty-five diagnoses representing common and at-risk for mortality diagnoses were studied. Interrupted time series analyses were applied. RESULTS: Face-to-face consultations decreased from 2935 to 2304 per 1000 inhabitants per year from the pre-pandemic period to the first pandemic year, with an increase in e-consultations from 60 to 846 per 1000 inhabitants per year. Consultations for common diagnoses decreased by 25.6%, whereas those for high-risk diagnoses decreased by 10.7%. In the group of common diagnoses, the decrease in average monthly consultation rates was less among the eldest compared to the youngest age group. A similar decrease was found in the group with multiple morbid conditions compared to single or no morbidity. CONCLUSIONS: The pandemic resulted in fewer face-to-face consultations, but there was a substantial rise in electronic consultations. Consultations for at-risk for mortality diagnoses decreased relatively less than for common diagnoses. Consultation rates for older adults and those with multiple decreased less, suggesting that sicker patients continued to visit their GP during the pandemic.

摘要

背景:2019年冠状病毒病(COVID-19)大流行期间的疾病预防策略可能会扰乱医疗服务的连续性。目的:(1)描述大流行之前和期间与全科医生(GP)接触的变化,(2)比较常见诊断和高危诊断的会诊率,以及(3)研究COVID-19限制措施对各患者亚组每月会诊率的影响。 方法:采用登记研究,数据来自挪威初级卫生保健登记处(NRPHC),时间跨度为2018年4月1日至2021年3月31日。会诊率的变化是主要结果。研究了代表常见诊断和死亡高危诊断的25种诊断。应用了中断时间序列分析。 结果:从大流行前时期到第一个大流行年份,面对面会诊从每年每1000名居民2935次降至2304次,电子会诊从每年每1000名居民60次增至846次。常见诊断的会诊减少了25.6%,而高危诊断的会诊减少了10.7%。在常见诊断组中,与最年轻年龄组相比,最年长者的平均每月会诊率下降幅度较小。与单一疾病或无疾病组相比,患有多种疾病的组也有类似程度的下降。 结论:大流行导致面对面会诊减少,但电子会诊大幅增加。死亡高危诊断的会诊减少幅度相对小于常见诊断。老年人和患有多种疾病者的会诊率下降幅度较小,这表明病情较重的患者在大流行期间仍继续就诊于全科医生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4544/12377136/5e36d125e2f7/IPRI_A_2491762_F0003_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4544/12377136/d70f5bc92ba1/IPRI_A_2491762_F0001_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4544/12377136/08bcec76f004/IPRI_A_2491762_F0002_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4544/12377136/5e36d125e2f7/IPRI_A_2491762_F0003_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4544/12377136/d70f5bc92ba1/IPRI_A_2491762_F0001_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4544/12377136/08bcec76f004/IPRI_A_2491762_F0002_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4544/12377136/5e36d125e2f7/IPRI_A_2491762_F0003_C.jpg

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[1]
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本文引用的文献

[1]
Long-term trends in English general practice consultation rates from 1995 to 2021: a retrospective analysis of two electronic health records databases.

BMJ Open. 2024-12-5

[2]
Mental health help-seeking behaviour in men.

J Adv Nurs. 2024-3

[3]
Interpreting technology: Use and non-use of doctor-patient video consultations in Danish general practice.

Soc Sci Med. 2023-10

[4]
Quick adaptation of the organisation of general practices during the COVID-19 pandemic in the Netherlands.

BMC Prim Care. 2023-8-31

[5]
Consultation Rate and Mode by Deprivation in English General Practice From 2018 to 2022: Population-Based Study.

JMIR Public Health Surveill. 2023-5-2

[6]
Continuity of care and mortality for patients with chronic disease: an observational study using Norwegian registry data.

Fam Pract. 2023-12-22

[7]
German general practitioners' experiences during the COVID-19 pandemic and how it affected their patient care: A qualitative study.

Eur J Gen Pract. 2023-12

[8]
Effect of lifting COVID-19 restrictions on utilisation of primary care services in Nepal: a difference-in-differences analysis.

BMJ Open. 2022-11-29

[9]
Contacts in general practice during the COVID-19 pandemic: a register-based study.

Br J Gen Pract. 2022-11

[10]
Socioeconomic status is associated with healthcare seeking behaviour and disease burden in young adults with asthma - A nationwide cohort study.

Chron Respir Dis. 2022

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