SARS-COV-2 大流行后基层医疗团队的重组。加泰罗尼亚和西班牙在 PRICOV 研究中的差异。

IF 1.6 Q3 HEALTH POLICY & SERVICES Health Services Management Research Pub Date : 2024-07-21 DOI:10.1177/09514848241265784
Antoni Peris Grao, Núria Freixenet, Toni Mora, David Roche
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引用次数: 0

摘要

背景:西班牙各地区当局对初级保健服务的管理方式各不相同。加泰罗尼亚比西班牙其他地区早近二十年开始提供和设计服务,并在初级医疗中发展了护士的角色和任务转移。目的:这项工作确定了欧洲 PRICOV-19 研究答案中加泰罗尼亚与西班牙其他地区提交的答案之间的差异,这些差异涉及在 SARS-CoV-2-2019 大流行期间如何组织初级医疗团队 (PCT)、任务和角色如何变化以及大流行对医疗服务提供者的影响。首先,我们计算了二元关系,并使用或然关联和非配对 Wilcoxon 分析法进行了检验:此外,我们还利用个人和全科医生诊所的一系列特征对多重线性回归进行了估计,并按地点类型对标准误差进行了聚类:结果:在适应新任务、解决大多数健康问题的能力以及初级保健的具体可及性方面发现了主要的统计学差异。加泰罗尼亚地区对新任务适应性的满意度(41.9% 满意,30.2% 不满意)高于西班牙其他地区(50.9% 不满意)。此外,加泰罗尼亚地区的全科医生比西班牙其他地区的全科医生更多地将慢性病患者列入广泛的随访名单。这些差异可能与加泰罗尼亚赋予家庭医生以外的初级保健专业人员权力的战略有关:考虑到未来的流行病、人口老龄化和专业人员短缺问题,我们指出了初级医疗保健中心组织的这些变化可能带来的益处,以及对中心设计进行审查的必要性。
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Primary care team reorganisation after the SARS-COV-2 pandemic. Differences between Catalonia and Spain in the PRICOV study.

Background: Spanish primary care services are managed differently by each region's authorities. Catalonia started its services provision and design nearly two decades before other Spanish regions and developed nurses' roles and task shifting in primary care.

Purpose: This work identifies differences in the Europe PRICOV-19 study answers between Catalonia and those submitted from the rest of Spain regarding how primary care teams (PCT) were organised during the SARS-CoV-2-2019 pandemic, how tasks and roles changed, and the pandemic's impact on the care providers. Initially, we computed bivariate relationships and tested using contingency association and unpaired Wilcoxon.

Analysis: Still, we estimated multiple linear regressions controlling with a list of individual and GP practice characteristics and clustering standard errors at the kind of location.

Results: Main statistically significant differences were found in the adaptation to the new tasks, the ability to solve most health problems, and specific accessibilities to primary care. In Catalonia, satisfaction with the adaptation to the new tasks was higher (41.9% satisfied and 30.2% neutral) than in the rest of Spain (50.9% dissatisfaction). Also, GPs in Catalonia reported to a greater extent than the rest of Spain that chronic patients were listed for extensive follow-up. These differences may be related to Catalonia's strategy for empowering primary care professionals other than family doctors.

Conclusions: Considering future pandemics, demographic ageing, and professional shortages, we point out the potential benefits of these changes in PCT organisations and the need to review the centres's design.

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来源期刊
Health Services Management Research
Health Services Management Research HEALTH POLICY & SERVICES-
CiteScore
4.00
自引率
4.80%
发文量
33
期刊介绍: Health Services Management Research (HSMR) is an authoritative international peer-reviewed journal which publishes theoretically and empirically rigorous research on questions of enduring interest to health-care organizations and systems throughout the world. Examining the real issues confronting health services management, it provides an independent view and cutting edge evidence-based research to guide policy-making and management decision-making. HSMR aims to be a forum serving an international community of academics and researchers on the one hand and healthcare managers, executives, policymakers and clinicians and all health professionals on the other. HSMR wants to make a substantial contribution to both research and managerial practice, with particular emphasis placed on publishing studies which offer actionable findings and on promoting knowledge mobilisation toward theoretical advances.
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