OpenSAFELY NHS Service Restoration Observatory 2: changes in primary care activity across six clinical areas during the COVID-19 pandemic
OpenSAFELY NHS Service Restoration Observatory 2: changes in primary care activity across six clinical areas during the COVID-19 pandemic
复制标题
OpenSAFELY NHS 服务恢复观察站 2：COVID-19 大流行期间六个临床领域初级保健活动的变化
DOI：
10.1101/2022.06.01.22275674
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
B. Goldacre
中科院分区：
文献类型：
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作者：
H. Curtis;B. Mackenna;Milan Wiedemann;Louis Fisher;R. Croker;C. Morton;P. Inglesby;A. Walker;J. Morley;A. Mehrkar;S. Bacon;G. Hickman;D. Evans;T. Ward;S. Davy;W. Hulme;O. Macdonald;Robin Conibere;T. Lewis;M. Myers;Shamila Wanninayake;Kiren Collison;C. Drury;Miriam Samuel;H. Sood;Andrea Cipriani;S. Fazel;Manuj Sharma;W. Baqir;C. Bates;John Parry;B. Goldacre
背景COVID-19大流行扰乱了广泛临床服务的医疗保健活动。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。使用常规收集的数据，我们的目的是描述在一般实践中编码的临床活动的数量和变化的变化：（i）心血管疾病，（ii）糖尿病，（iii）心理健康，（iv）女性和生殖健康，（v）筛查，（vi）与药物相关的过程。设计和设置在英国NHS的批准下，我们使用OpenSAFELY在全科实践中对2380万例患者记录进行了一项队列研究。方法我们使用CTV 3代码和关键字搜索从2019年1月至2020年12月选择常见的初级保健活动，列出每月各实践中代码使用的中位数和十分位数。结果我们发现，自COVID-19疫情爆发以来，基层医疗的临床活动发生了重大而广泛的变化，到2020年12月总体恢复良好。少数例外情况显示恢复不佳，需要进一步调查，例如精神健康，例如“抑郁中期审查”（与2019年12月相比，2020年12月的实践中位数为41.6%）。结论在人口规模的颗粒NHS GP数据可用于监测中断医疗服务，并指导缓解策略的发展。作者现在正在为这里确定的关键措施以及进一步的研究开发实时监测仪表板，使用初级保健数据来监测和减轻新冠肺炎对NHS的间接健康影响。
Background 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. Aims Using routinely collected data, our aim was to describe changes in the volume and variation of coded clinical activity in general practice in: (i) cardiovascular disease, (ii) diabetes, (iii) mental health, (iv) female and reproductive health, (v) screening, and (vi) processes related to medication. Design and setting With the approval of NHS England, we conducted a cohort study of 23.8 million patient records in general practice, in-situ using OpenSAFELY. Methods We selected common primary care activity using CTV3 codes and keyword searches from January 2019 - December 2020, presenting median and deciles of code usage across practices per month. Results We identified substantial and widespread changes in clinical activity in primary care 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, e.g. "Depression interim review" (median across practices in December 2020 -41.6% compared to December 2019). Conclusions Granular NHS GP 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 key measures identified here as well as further studies, using primary care data to monitor and mitigate the indirect health impacts of Covid-19 on the NHS.