Changes in the top 25 reasons for primary care visits during the COVID-19 pandemic in a high-COVID region of Canada.
Changes in the top 25 reasons for primary care visits during the COVID-19 pandemic in a high-COVID region of Canada.
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DOI：
10.1371/journal.pone.0255992
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Tu K
中科院分区：
文献类型：
--
作者：
Stephenson E;Butt DA;Gronsbell J;Ji C;O'Neill B;Crampton N;Tu K
我们的目的是确定在 COVID-19 大流行期间初级保健就诊原因的变化程度。我们使用多伦多大学基于实践的研究网络 (UTOPIAN) 的数据来比较 COVID-19 大流行爆发前后初级保健就诊的最常见原因，重点关注 25 个最常见诊断代码中每种代码的就诊次数和就诊患者人数。涉及虚拟护理的就诊比例被评估为次要结果。 UTOPIAN家庭医生（N = 379）在2019年3月14日至12月31日（大流行前期）期间进行了702,093次就诊，涉及264,942名患者；在2020年3月14日至12月31日（大流行期间）进行了667,612次就诊，涉及218,335名患者。焦虑是最常见的就诊原因，占疫情期间总就诊量的 9.2%，而去年这一比例为 6.5%。糖尿病和高血压仍然是疫情期间就诊的前 5 大原因，但就诊次数分别减少了 23.7% 和 26.2%，接受糖尿病和高血压护理的个体患者分别减少了 19.5% 和 28.8%。预防性护理就诊次数大幅减少，定期健康检查次数减少了 89.0%，健康婴儿就诊次数减少了 16.2%。在大流行期间，虚拟护理成为主要的护理形式（77.5％是虚拟就诊）。焦虑和抑郁就诊是虚拟就诊的最常见原因（90.6% 虚拟就诊）。 COVID-19 大流行期间初级保健就诊量的减少因就诊原因而异，其中因焦虑而就诊的人数有所增加，而预防性护理和慢性病就诊的人数则有所减少。对精神卫生服务的需求增加以及预防保健和慢性病管理方面的差距可能需要在初级保健方面做出重点努力。
We aimed to determine the degree to which reasons for primary care visits changed during the COVID-19 pandemic. We used data from the University of Toronto Practice Based Research Network (UTOPIAN) to compare the most common reasons for primary care visits before and after the onset of the COVID-19 pandemic, focusing on the number of visits and the number of patients seen for each of the 25 most common diagnostic codes. The proportion of visits involving virtual care was assessed as a secondary outcome. UTOPIAN family physicians (N = 379) conducted 702,093 visits, involving 264,942 patients between March 14 and December 31, 2019 (pre-pandemic period), and 667,612 visits, involving 218,335 patients between March 14 and December 31, 2020 (pandemic period). Anxiety was the most common reason for visit, accounting for 9.2% of the total visit volume during the pandemic compared to 6.5% the year before. Diabetes and hypertension remained among the top 5 reasons for visit during the pandemic, but there were 23.7% and 26.2% fewer visits and 19.5% and 28.8% fewer individual patients accessing care for diabetes and hypertension, respectively. Preventive care visits were substantially reduced, with 89.0% fewer periodic health exams and 16.2% fewer well-baby visits. During the pandemic, virtual care became the dominant care format (77.5% virtual visits). Visits for anxiety and depression were the most common reasons for a virtual visit (90.6% virtual visits). The decrease in primary care visit volumes during the COVID-19 pandemic varied based on the reason for the visit, with increases in visits for anxiety and decreases for preventive care and visits for chronic diseases. Implications of increased demands for mental health services and gaps in preventive care and chronic disease management may require focused efforts in primary care.
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DOI：
10.1503/cmaj.202303
发表时间：
2021-02-08
期刊：
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
影响因子：
--
作者：
Glazier RH;Green ME;Wu FC;Frymire E;Kopp A;Kiran T
通讯作者：
Kiran T
DOI：
10.1177/0706743715621254
发表时间：
2016-02-01
影响因子：
4
作者：
Gandhi, Sima;Chiu, Maria;Kurdyak, Paul
通讯作者：
Kurdyak, Paul
影响因子：
3.6
作者：
Kearon J;Risdon C
通讯作者：
Risdon C
DOI：
10.1016/s2468-2667(20)30288-7
发表时间：
2021-03
期刊：
The Lancet. Public health
影响因子：
--
作者：
Carr MJ;Steeg S;Webb RT;Kapur N;Chew-Graham CA;Abel KM;Hope H;Pierce M;Ashcroft DM
通讯作者：
Ashcroft DM
影响因子：
1.9
作者：
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Freer PE