OpenSAFELY NHS Service Restoration Observatory 2: changes in primary care clinical activity in England during the COVID-19 pandemic.
OpenSAFELY NHS Service Restoration Observatory 2: changes in primary care clinical activity in England during the COVID-19 pandemic.
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DOI：
10.3399/bjgp.2022.0301
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发表时间：
2023-05
期刊：
影响因子：
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通讯作者：
OpenSAFELY Collaborative
中科院分区：
文献类型：
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作者：
Curtis HJ;MacKenna B;Wiedemann M;Fisher L;Croker R;Morton CE;Inglesby P;Walker AJ;Morley J;Mehrkar A;Bacon SC;Hickman G;Evans D;Ward T;Davy S;Hulme WJ;Macdonald O;Conibere R;Lewis T;Myers M;Wanninayake S;Collison K;Drury C;Samuel M;Sood H;Cipriani A;Fazel S;Sharma M;Baqir W;Bates C;Parry J;Goldacre B;OpenSAFELY Collaborative
COVID-19大流行扰乱了广泛临床服务的医疗活动。NHS于2020年3月停止了非紧急工作，后来建议在冬季之前尽可能将服务恢复到接近正常水平。描述六个临床领域的全科医学编码临床活动的数量和变化：心血管疾病、糖尿病、精神健康、女性和生殖健康、筛查和相关程序以及与药物相关的过程。在英国NHS的批准下，使用OpenSAFELY在全科实践中对2380万例患者记录进行了一项队列研究。从2019年1月至2020年12月，使用临床术语第3版代码和关键字搜索分析了常见的初级保健活动，列出了每月各实践中代码使用的中位数和十分位数。自2019冠状病毒病疫情爆发以来，基层医疗的临床活动出现了重大而广泛的变化，并于二零二零年十二月普遍恢复良好。少数例外情况显示恢复情况欠佳，需要进一步调查，例如精神健康（例如，就“抑郁中期审查”而言，2020年12月各业务的中位发生率较2019年12月下降41. 6%）。人口规模的粒状NHS全科实践数据可用于监测医疗服务中断，并指导缓解策略的制定。作者现在正在为本研究中确定的关键措施开发实时监测仪表板，以及使用初级保健数据进行进一步研究，以监测和减轻COVID-19对NHS的间接健康影响。
The COVID-19 pandemic has disrupted healthcare activity across a broad range of clinical services. The NHS stopped non-urgent work in March 2020, later recommending services be restored to near-normal levels before winter where possible. To describe changes in the volume and variation of coded clinical activity in general practice across six clinical areas: cardiovascular disease, diabetes, mental health, female and reproductive health, screening and related procedures, and processes related to medication. With the approval of NHS England, a cohort study was conducted of 23.8 million patient records in general practice, in situ using OpenSAFELY. Common primary care activities were analysed using Clinical Terms Version 3 codes and keyword searches from January 2019 to December 2020, presenting median and deciles of code usage across practices per month. Substantial and widespread changes in clinical activity in primary care were identified since the onset of the COVID-19 pandemic, with generally good recovery by December 2020. A few exceptions showed poor recovery and warrant further investigation, such as mental health (for example, for ‘Depression interim review’ the median occurrences across practices in December 2020 was down by 41.6% compared with December 2019). Granular NHS general practice data at population-scale can be used to monitor disruptions to healthcare services and guide the development of mitigation strategies. The authors are now developing real-time monitoring dashboards for the key measures identified in this study, as well as further studies using primary care data to monitor and mitigate the indirect health impacts of COVID-19 on the NHS.