Paediatric primary care in Germany during the early COVID-19 pandemic: the calm before the storm
Autor: | Hans Martin Bosse, Daniela Vesterling-Hörner, Hanna Renk, Mehrsad Klemm, Katharina Weil, Katharina Remke, Tarik el Scheich, Malte Kohns Vasconcelos |
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Rok vydání: | 2021 |
Předmět: |
Medicine (General)
medicine.medical_specialty Coronavirus disease 2019 (COVID-19) Adolescent Population Primary care child Health community-acquired infections 03 medical and health sciences R5-920 0302 clinical medicine Germany Surveys and Questionnaires Health care Pandemic medicine Humans 030212 general & internal medicine Pediatricians education Child Quality of Health Care Original Research Response rate (survey) education.field_of_study High prevalence Primary Health Care business.industry Public health insurance SARS-CoV-2 Public Health Environmental and Occupational Health Infant Newborn COVID-19 Infant Family medicine Child Preschool Chronic Disease Family Practice business 030217 neurology & neurosurgery |
Zdroj: | Family Medicine and Community Health Family Medicine and Community Health, Vol 9, Iss 2 (2021) |
ISSN: | 2009-8774 |
Popis: | ObjectivesGlobally, the COVID-19 pandemic has a major impact on healthcare provision. The effects in primary care are understudied. This study aimed to explore changes in consultation numbers and patient management during the COVID-19 pandemic, and to identify challenges for patient care.DesignSurvey of paediatric primary care practices on consultation numbers and patient management changes, and semistructured interviews to identify challenges for patient care. Surveys and interviews were partially linked in an explanatory sequential design to identify patient groups perceived to be at higher risk for worse care during the pandemic.SettingIn and around Düsseldorf, a densely populated area in Western Germany. The primary care facilities are spread over an area with approximately 2 million inhabitants.ParticipantsPrimary care in Germany is provided through practices run by self-employed specialist physicians that are contracted to offer services to patients under public health insurance which is compulsory to the majority of the population. The sample contained 44 paediatric primary care practices in the area, the response rate was 50%.ResultsNumbers of consultations for scheduled developmental examinations remained unchanged compared with the previous year while emergency visits were strongly reduced (mean 87.3 less/week in March–May 2020 compared with 2019, median reduction 55.0%). Children dependent on developmental therapy and with chronic health conditions were identified as patient groups receiving deteriorated care. High patient numbers, including of mildly symptomatic children presenting for health certificates, in combination with increased organisational demands and expected staff outages are priority concerns for the winter.ConclusionsPrimary care paediatricians offered stable service through the early pandemic but expected strained resources for the upcoming winter. Unambiguous guidance on which children should present to primary care and who should be tested would help to allocate resources appropriately, and this guidance needs to consider age group specific issues including high prevalence of respiratory symptoms, dependency on carers and high contact rates. |
Databáze: | OpenAIRE |
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