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新冠疫情与医疗服务的六个“A”——可及性、可负担性、可得性、适宜性、充分性和依从性。

COVID-19 pandemic versus six "A"s of health care services - accessibility, affordability, availability, appropriateness, adequacy, and adherence.

作者信息

Sandhya Kalidas, Palanisamy Priyadharsini R, Sandhya R

机构信息

Department of Pharmacology, JIPMER, Karaikal, Pondicherry, India.

出版信息

J Family Med Prim Care. 2025 Apr;14(4):1320-1324. doi: 10.4103/jfmpc.jfmpc_1535_24. Epub 2025 Apr 25.

Abstract

BACKGROUND AND RATIONALE

COVID-19 pandemic resulted in a huge setback in health care sector causing morbidity, mortality, lack of manpower, resources, in hospitals. Apart from the direct effects of the disease, the indirect effects include, lockdowns, restriction of movement of people for food, work, medicines, etc. There are certain non-communicable diseases for which lifelong treatment and continuation of care is required and the patients suffering from these diseases were also highly affected during pandemic. The major pillars of health care services are accessibility, affordability, availability appropriateness, adequacy and adherence and it is true that the pandemic had its impact on all these pillars.

METHODOLOGY

A prospective cross sectional study in which 284 patients with NCD answered a questionaire and the responses were analysed.

RESULTS

There was a lack of accessibility (48%), affordability (42%) availability (54%) appropriateness and 71% of population took self-medication during the period. There was discontinuity in 16% of the population and the reasons for discontinuation include depression, lack of motivation, forgetfulness, financial crisis etc.

CONCLUSION

The pandemic exerted a greater influence on saturation of health care services by increasing the mortality, morbidity and as a consequence decreased the health care services to communicable/non-communicable diseases. Our study shows the need and demand for robust health care services during critical times.

摘要

背景与理论依据

新冠疫情给医疗保健领域带来了巨大挫折,导致医院出现发病率、死亡率上升,人力和资源短缺的情况。除了疾病的直接影响外,间接影响还包括封锁、限制人们获取食物、工作、药品等的行动。某些非传染性疾病需要终身治疗和持续护理,而患有这些疾病的患者在疫情期间也受到了严重影响。医疗保健服务的主要支柱包括可及性、可负担性、可得性、适宜性、充分性和依从性,疫情确实对所有这些支柱都产生了影响。

方法

一项前瞻性横断面研究,284名非传染性疾病患者回答了一份问卷,并对回答进行了分析。

结果

在此期间,存在可及性不足(48%)、可负担性不足(42%)、可得性不足(54%)、适宜性不足的情况,71%的人群自行用药。16%的人群出现了治疗中断,中断原因包括抑郁、缺乏动力、遗忘、金融危机等。

结论

疫情通过增加死亡率和发病率,对医疗保健服务的饱和度产生了更大影响,从而减少了对传染病/非传染性疾病的医疗保健服务。我们的研究表明,在关键时期对强大的医疗保健服务有需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a261/12088546/da69395bac6c/JFMPC-14-1320-g001.jpg

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