在 COVID-19 大流行期间维持非传染性疾病 (NCD) 服务:泰国的经验教训。

IF 7.1 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH BMJ Global Health Pub Date : 2024-10-22 DOI:10.1136/bmjgh-2023-014695
Melanie Coates, Paul Li Jen Cheh, Thanathip Suenghataiphorn, Wasin Laohavinij, Aungsumalee Pholpark, Natchaya Ritthisirikul, Sirithorn Khositchaiwat, Piya Hanvoravongchai
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引用次数: 0

摘要

COVID-19 大流行给全球卫生系统带来了巨大挑战,需要将资源用于应对大流行,同时维持基本的医疗服务。在 2021 年 8 月至 2022 年 6 月期间,我们通过文献综述和关键信息提供者访谈,确定了非传染性疾病(NCD)服务在大流行期间受到的影响,以及哪些良好实践有助于支持不间断的医疗服务。在现有强大医疗保健系统的背景下,泰国表现出了强有力的中央应对协调能力,最大限度地减少了资金中断,并利用现有基础设施有效地利用了有限的资源,例如通过动员医疗保健劳动力。一项关键的干预措施是重新设计非传染性疾病系统,例如通过 "新常态医疗服务 "倡议。这促进了数字创新,包括远程自我监测、患者风险分层和替代药物配发。在 COVID-19 大流行期间,非传染性疾病服务的使用受到了干扰;然而,在现有的强大系统基础上进行的新调整对于减轻干扰至关重要。然而,挑战依然存在,包括确保重新设计举措的持续评估、调整和可持续性。通过知识共享、国际合作和进一步完善 "新常态 "模式,这种学习有可能在更大范围内推动积极的卫生系统变革。
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Maintaining non-communicable disease (NCD) services during the COVID-19 pandemic: lessons from Thailand.

The COVID-19 pandemic presented a significant challenge to health systems worldwide, requiring resources to be directed to the pandemic response while also maintaining essential health services. Those with non-communicable diseases (NCDs) are particularly vulnerable to COVID-19, and interrupted care resulting from the pandemic has the potential to worsen morbidity and mortality.We used narrative literature review and key informant interviews between August 2021 and June 2022 to identify how NCD services were impacted during the pandemic and which good practices helped support uninterrupted care.On the background of an existing strong healthcare system, Thailand exhibited strong central coordination of the response, minimised funding interruptions and leveraged existing infrastructure to make efficient use of limited resources, such as through mobilising healthcare workforce. A key intervention has been redesigning NCD systems such as through the 'New Normal Medical Services' initiative. This has promoted digital innovations, including remote self-monitoring, patient risk stratification and alternative medication dispensing. Emphasis has been placed on multidisciplinary, patient-centred and community-centred care.NCD service utilisation has been disrupted during the COVID-19 pandemic; however, newly adapted efforts on top of existing robust systems have been critical to mitigating disruptions. Yet challenges remain, including ensuring ongoing evaluation, adaptation and sustainability of redesign initiatives. This learning offers the potential to further positive health systems change on a wider scale, through sharing knowledge, international collaboration and further refinement of the 'new normal' model.

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来源期刊
BMJ Global Health
BMJ Global Health Medicine-Health Policy
CiteScore
11.40
自引率
4.90%
发文量
429
审稿时长
18 weeks
期刊介绍: BMJ Global Health is an online Open Access journal from BMJ that focuses on publishing high-quality peer-reviewed content pertinent to individuals engaged in global health, including policy makers, funders, researchers, clinicians, and frontline healthcare workers. The journal encompasses all facets of global health, with a special emphasis on submissions addressing underfunded areas such as non-communicable diseases (NCDs). It welcomes research across all study phases and designs, from study protocols to phase I trials to meta-analyses, including small or specialized studies. The journal also encourages opinionated discussions on controversial topics.
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