PDF(Pubmed)
Abstract：
UNASSIGNED: A total of 7,307 Ukrainian refugees moved to Antwerp, Belgium, during the study period (01 April 2022 to 31 December 2022). The city\'s administration set up three care centers where these people were introduced to the Belgian primary care system, a medical file was created, and acute/preventive/chronic care was delivered. This community case study analyzes the organization and contents of care and reflects upon its meaning for the mainstream healthcare system.
UNASSIGNED: This is an observational study using routine electronic medical record data to measure the uptake of care. For a sample of 200 subjects, a retrospective chart review was conducted.
UNASSIGNED: All refugees with a medical file at one of the three participating care centers were included.
UNASSIGNED: For the observational study, 2,261 patients were reached (30% of the potential users), and 6,450 contacts were studied. The nurses (including midwives) conducted 4,929 out of 6,450 (76%) of all consultations, while the general practitioners (GPs) conducted 1,521 out of 6,450 (24%). Of the nurse consultations, 955 (19%) were followed by another nurse consultation and 866 (18%) by a GP consultation. In the structured case reviews, most contacts were concerned with acute problems (609 out of 1,074, 57%). The most prevalent reasons for encounters and diagnoses were typical primary care issues. The nurses were able to manage half of the cases independently (327, 55%), referred 37% (217) of cases to the GP, and consulted a GP (live, by telephone, or a dedicated app) for 8% (48) of cases. GPs mostly prescribed drugs, referred to a medical specialist, and advised over-the-counter drugs, while nurses more often advised over-the-counter drugs (mostly paracetamol, nose sprays, and anti-inflammatory drugs), provided non-medical advice, or ordered laboratory tests.
UNASSIGNED: The medical care points delivered mostly typical acute primary care in this first phase, with a key role for nurses. The care points did not sufficiently take up chronic diseases and mental health problems. These results will inform policymakers on the use of primary care centers for newly arriving patients in times of a large influx. A nurse-first model seems feasible and efficient, but evaluation of safety and quality of care is needed. Once the acute phase of this crisis fades away, questions about the comprehensiveness, continuity, and integration of care for migrants remain relevant.
UNASSIGNED: This is an observational study using routine electronic medical record data to measure the uptake of care. For a sample of 200 subjects, a retrospective chart review was conducted.
UNASSIGNED: All refugees with a medical file at one of the three participating care centers were included.
UNASSIGNED: For the observational study, 2,261 patients were reached (30% of the potential users), and 6,450 contacts were studied. The nurses (including midwives) conducted 4,929 out of 6,450 (76%) of all consultations, while the general practitioners (GPs) conducted 1,521 out of 6,450 (24%). Of the nurse consultations, 955 (19%) were followed by another nurse consultation and 866 (18%) by a GP consultation. In the structured case reviews, most contacts were concerned with acute problems (609 out of 1,074, 57%). The most prevalent reasons for encounters and diagnoses were typical primary care issues. The nurses were able to manage half of the cases independently (327, 55%), referred 37% (217) of cases to the GP, and consulted a GP (live, by telephone, or a dedicated app) for 8% (48) of cases. GPs mostly prescribed drugs, referred to a medical specialist, and advised over-the-counter drugs, while nurses more often advised over-the-counter drugs (mostly paracetamol, nose sprays, and anti-inflammatory drugs), provided non-medical advice, or ordered laboratory tests.
UNASSIGNED: The medical care points delivered mostly typical acute primary care in this first phase, with a key role for nurses. The care points did not sufficiently take up chronic diseases and mental health problems. These results will inform policymakers on the use of primary care centers for newly arriving patients in times of a large influx. A nurse-first model seems feasible and efficient, but evaluation of safety and quality of care is needed. Once the acute phase of this crisis fades away, questions about the comprehensiveness, continuity, and integration of care for migrants remain relevant.
摘要：
■共有7,307名乌克兰难民移居安特卫普，比利时,在研究期间（2022年4月1日至2022年12月31日）。市政府建立了三个护理中心，这些人被引入比利时初级保健系统，创建了一个医疗文件，并提供了急性/预防性/慢性护理。本社区案例研究分析了护理的组织和内容，并反思了其对主流医疗保健系统的意义。
■这是一项观察性研究，使用常规电子病历数据来测量护理的摄取。对于200名受试者的样本，进行了回顾性图表审查.
■在三个参与护理中心之一拥有医疗档案的所有难民都包括在内。
■对于观察性研究，达到2,261名患者（潜在用户的30％），并对6450名接触者进行了研究。护士(包括助产士)在所有咨询的6450次(76%)中进行了4929次,而全科医生(全科医生)在6,450人中有1,521人(24%)。在护士咨询中，955（19％）随后是另一位护士咨询，866（18％）随后是全科医生咨询。在结构化案例审查中，大多数接触者与严重问题有关(1074人中有609人，占57%)。遇到和诊断的最普遍原因是典型的初级保健问题。护士能够独立管理一半的病例（327，55％），将37%(217)的病例转介给全科医生，并咨询了全科医生(现场，通过电话,或专用应用程序)适用于8%(48)的病例。全科医生主要是处方药，转诊给医学专家,并建议使用非处方药，虽然护士更经常建议非处方药(主要是扑热息痛，喷鼻剂,和抗炎药），提供非医疗建议，或订购实验室测试。
■在第一阶段，医疗护理点主要提供典型的急性初级保健，对护士有重要作用。护理点没有充分解决慢性病和心理健康问题。这些结果将为决策者提供有关在大量涌入时使用初级保健中心治疗新到达的患者的信息。护士优先模式似乎可行且有效，但是需要评估护理的安全性和质量。一旦危机的急性阶段消失，关于全面性的问题，连续性,移民护理的整合仍然重要。
■这是一项观察性研究，使用常规电子病历数据来测量护理的摄取。对于200名受试者的样本，进行了回顾性图表审查.
■在三个参与护理中心之一拥有医疗档案的所有难民都包括在内。
■对于观察性研究，达到2,261名患者（潜在用户的30％），并对6450名接触者进行了研究。护士(包括助产士)在所有咨询的6450次(76%)中进行了4929次,而全科医生(全科医生)在6,450人中有1,521人(24%)。在护士咨询中，955（19％）随后是另一位护士咨询，866（18％）随后是全科医生咨询。在结构化案例审查中，大多数接触者与严重问题有关(1074人中有609人，占57%)。遇到和诊断的最普遍原因是典型的初级保健问题。护士能够独立管理一半的病例（327，55％），将37%(217)的病例转介给全科医生，并咨询了全科医生(现场，通过电话,或专用应用程序)适用于8%(48)的病例。全科医生主要是处方药，转诊给医学专家,并建议使用非处方药，虽然护士更经常建议非处方药(主要是扑热息痛，喷鼻剂,和抗炎药），提供非医疗建议，或订购实验室测试。
■在第一阶段，医疗护理点主要提供典型的急性初级保健，对护士有重要作用。护理点没有充分解决慢性病和心理健康问题。这些结果将为决策者提供有关在大量涌入时使用初级保健中心治疗新到达的患者的信息。护士优先模式似乎可行且有效，但是需要评估护理的安全性和质量。一旦危机的急性阶段消失，关于全面性的问题，连续性,移民护理的整合仍然重要。
