OpenSAFELY NHS Service Restoration Observatory 1: primary care clinical activity in England during the first wave of COVID-19.
OpenSAFELY NHS Service Restoration Observatory 1: primary care clinical activity in England during the first wave of COVID-19.
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DOI：
10.3399/bjgp.2021.0380
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发表时间：
2022-01
期刊：
影响因子：
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通讯作者：
(The OpenSAFELY Collaborative)
中科院分区：
文献类型：
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作者：
Curtis HJ;MacKenna B;Croker R;Inglesby P;Walker AJ;Morley J;Mehrkar A;Morton CE;Bacon S;Hickman G;Bates C;Evans D;Ward T;Cockburn J;Davy S;Bhaskaran K;Schultze A;Rentsch CT;Williamson EJ;Hulme WJ;McDonald HI;Tomlinson L;Mathur R;Drysdale H;Eggo RM;Wing K;Wong AY;Forbes H;Parry J;Hester F;Harper S;Evans SJ;Douglas IJ;Smeeth L;Goldacre B;(The OpenSAFELY Collaborative)
COVID-19 大流行扰乱了医疗保健活动。 NHS 于 2020 年 3 月停止了非紧急工作，随后建议尽可能在冬季之前将服务恢复到接近正常水平。以呼吸系统疾病和实验室操作为例，描述一般实践中编码临床活动的数量和变化。代表英国 NHS，使用 OpenSAFELY 对 2380 万份全科医疗患者记录进行了现场队列研究。描述了 2019 年 1 月至 2020 年 9 月使用临床术语版本 3 代码和关键词搜索的活动。疫情期间全科医疗活动有所下降，但到 9 月份基本恢复。实验室测试的编码活动大幅下降，到 9 月份基本恢复到大流行前的水平。一个例外是国际标准化比率检验，下降幅度较小（2020 年每 1000 名患者的中位检验数：2 月 8.0；4 月 6.2；9 月 6.9）。呼吸道症状的记录模式受到的影响较小，遵循预期的季节性模式，并被归类为“无变化”。呼吸道感染持续下降，但到 9 月份仍未恢复到大流行前的水平。哮喘评论略有下降但有所恢复，而慢性阻塞性肺疾病评论仍低于基线。提供了一个开源软件框架来描述前所未有的初级保健数据规模中临床活动的趋势和变化。 COVD-19 大流行导致医疗保健活动发生重大变化。大多数实验室检测显示大幅减少，到 9 月份基本恢复到接近正常水平，一些重要检测受影响较小，呼吸道疾病代码的记录也参差不齐。
The COVID-19 pandemic has disrupted healthcare activity. The NHS stopped non-urgent work in March 2020, later recommending services be restored to near-normal levels before winter where possible. To describe the volume and variation of coded clinical activity in general practice, taking respiratory disease and laboratory procedures as examples. Working on behalf of NHS England, a cohort study was conducted of 23.8 million patient records in general practice, in situ using OpenSAFELY. Activity using Clinical Terms Version 3 codes and keyword searches from January 2019 to September 2020 are described. Activity recorded in general practice declined during the pandemic, but largely recovered by September. There was a large drop in coded activity for laboratory tests, with broad recovery to pre-pandemic levels by September. One exception was the international normalised ratio test, with a smaller reduction (median tests per 1000 patients in 2020: February 8.0; April 6.2; September 6.9). The pattern of recording for respiratory symptoms was less affected, following an expected seasonal pattern and classified as ‘no change’. Respiratory infections exhibited a sustained drop, not returning to pre-pandemic levels by September. Asthma reviews experienced a small drop but recovered, whereas chronic obstructive pulmonary disease reviews remained below baseline. An open-source software framework was delivered to describe trends and variation in clinical activity across an unprecedented scale of primary care data. The COVD-19 pandemic led to a substantial change in healthcare activity. Most laboratory tests showed substantial reduction, largely recovering to near-normal levels by September, with some important tests less affected and recording of respiratory disease codes was mixed.