背景:老年人口的人口统计学变化,随着非传染性疾病患病率的增加,以及从医院护理到家庭护理的转变对初级卫生保健的需求,这需要多专业协作和基于团队的工作组织。COVID-19大流行以各种方式影响了医疗保健,例如加强感染控制措施,改变工作习惯,和增加的工作量。
目的:本研究旨在调查初级保健实践与组织、以及COVID-19大流行期间的质量和安全性变化。
方法:在一项大型在线调查中收集了来自38个国家的数据,PRICOV-19研究。对于这篇论文,参与的做法被归类为“只有全科医生”,包括仅与全科医生(GP)和/或GP学员的实践,没有任何其他医疗保健专业人员(n=1,544),和“多专业,“包括至少一名GP或GP受训人员以及一名或多名其他卫生专业人员的实践(n=3,936)。
结果:与COVID-19大流行之前和期间相比,这两类做法在感染控制常规方面都有所改善。更大比例的多专业实践改变了他们的惯例,以保护脆弱的患者。电话分诊被用于更多的“多专业”实践中,而“只有全科医生”更有可能进行视频咨询,作为身体访问的替代方案。这两种做法都报告说,在大流行期间,审查新指南和科学文献的时间减少了。然而,与大流行之前相比,双方都有更多的会议讨论指令。
结论:多专业团队更热衷于对护理组织进行变革,以保护弱势患者。然而,发现只有全科医生的做法与视频咨询更一致,也许反映了密切的医患关系。相比之下,电话分诊在多专业团队中使用得更多。
BACKGROUND: Changes in demographics with an older population, the illness panorama with increasing prevalence of non-communicable diseases, and the shift from hospital care to home-based care place demand on primary health care, which requires multiprofessional collaboration and team-based organization of work. The COVID-19 pandemic affected health care in various ways, such as heightened infection control measures, changing work practices, and increased workload.
OBJECTIVE: This study aimed to investigate the association between primary care practices\' organization, and quality and safety changes during the COVID-19 pandemic.
METHODS: Data were collected from 38 countries in a large online survey, the PRICOV-19 study. For this paper, the participating practices were categorized as \"Only GPs\", comprising practices with solely general practitioners (GPs) and/or GP trainees, without any other health care professionals (n = 1,544), and \"Multiprofessional,\" comprising practices with at least one GP or GP trainee and one or more other health professionals (n = 3,936).
RESULTS: Both categories of practices improved in infection control routines when compared before and during the COVID-19 pandemic. A larger proportion of the multiprofessional practices changed their routines to protect vulnerable patients. Telephone triage was used in more \"Multiprofessional\" practices, whereas \"Only GPs\" were more likely to perform video consultations as an alternative to physical visits. Both types of practices reported that the time to review new guidelines and scientific literature decreased during the pandemic. However, both had more meetings to discuss directives than before the pandemic.
CONCLUSIONS: Multiprofessional teams were keener to introduce changes to the care organization to protect vulnerable patients. However, practices with only GPs were found to be more aligned with video consultations, perhaps reflecting the close patient-doctor relationship. In contrast, telephone triage was used more in multiprofessional teams.