A qualitative study of high-performing primary care practices during the COVID-19 pandemic.
A qualitative study of high-performing primary care practices during the COVID-19 pandemic.
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DOI：
10.1186/s12875-021-01589-4
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发表时间：
2021-11-25
影响因子：
2.9
通讯作者：
Berry CA
中科院分区：
文献类型：
--
作者：
Albert SL;Paul MM;Nguyen AM;Shelley DR;Berry CA
在整个COVID-19疫情期间，基层医疗实践一直处于医疗保健服务提供的前线。我们研究的目的是了解初级保健实践的早期流行经验，他们如何适应慢性病管理和预防保健的护理流程，以及这些实践的服务提供适应的未来潜力。我们在2020年3月至5月期间采访了位于美国各地的22个高绩效初级保健实践的44名提供者和工作人员。由于这项研究的时间敏感性，使用修改后的快速评估程序对访谈进行了转录和编码。据报告，在2019冠状病毒病大流行期间，采用了各种适应护理的做法，包括通过增加使用远程医疗访问来保持安全和社交距离，使用疾病登记来识别并主动接触患者，提供远程患者教育，以及将更多基于家庭的监测纳入护理。常规筛查和检测速度大大放慢，导致人们担心检测延迟。在此期间，资源较少、健康素养较低和老年人的患者最难接触和管理。我们的研究结果表明，为远程慢性病管理和预防保健开发的初级保健结构和流程正在迅速发展。新出现的经过调整的护理程序，特别是远程提供护理，是有希望的，可能会持续到大流行病结束后，但必须解决公平问题（例如，通过支付改革）确保弱势群体获得同样的福利。
Primary care practices have remained on the frontline of health care service delivery throughout the COVID-19 pandemic. The purpose of our study was to understand the early pandemic experience of primary care practices, how they adapted care processes for chronic disease management and preventive care, and the future potential of these practices’ service delivery adaptations. We interviewed 44 providers and staff at 22 high-performing primary care practices located throughout the United States between March and May 2020. Interviews were transcribed and coded using a modified rapid assessment process due to the time-sensitive nature of the study. Practices reported employing a variety of adaptations to care during the COVID-19 pandemic including maintaining safe and socially distanced access through increased use of telehealth visits, using disease registries to identify and proactively outreach to patients, providing remote patient education, and incorporating more home-based monitoring into care. Routine screening and testing slowed considerably, resulting in concerns about delayed detection. Patients with fewer resources, lower health literacy, and older adults were the most difficult to reach and manage during this time. Our findings indicate that primary care structures and processes developed for remote chronic disease management and preventive care are evolving rapidly. Emerging adapted care processes, most notably remote provision of care, are promising and may endure beyond the pandemic, but issues of equity must be addressed (e.g., through payment reform) to ensure vulnerable populations receive the same benefit.
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影响因子：
5.4
作者：
Razavi AC;Kelly TN;He J;Fernandez C;Whelton PK;Krousel-Wood M;Bazzano LA
通讯作者：
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影响因子：
5.2
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Sterling MR
影响因子：
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Federman AD
影响因子：
39.2
作者：
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通讯作者：
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影响因子：
9.7
作者：
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通讯作者：
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