Difference in general practice telehealth utilisation associated with birth country during Covid-19 from two Australian states.

OBJECTIVE: Telehealth has been an integral part of ensuring continued general practice access during the Covid-19 pandemic. Whether telehealth was similarly adopted across different ethnic, cultural, and linguistic groups in Australia is unknown. In this study, we assessed how telehealth utilisation differed by birth country. METHODS: In this retrospective observational study, electronic health record data from 799 general practices across Victoria and New South Wales, Australia between March 2020 to November 2021 were extracted (12,403,592 encounters from 1,307,192 patients). Multivariate generalised estimating equation models were used to assess the likelihood of a telehealth consultation (against face-to-face consultation) by birth country (relative to Australia or New-Zealand born patients), education index, and native language (English versus others). RESULTS: Patients born in South-eastern Asia (aOR 0.54; 95%CI 0.52 - 0.55), Eastern Asia (aOR 0.63; 95%CI 0.60 - 0.66), and India (aOR 0.64; 95%CI 0.63 - 0.66) had a lower likelihood of having a telehealth consultation compared to those born in Australia or New Zealand. Northern America, British Isles, and most European countries did not present with a statistically significant difference. Additionally, higher education levels (aOR 1.34 95%CI 1.26 - 1.42) was associated with an increase in the likelihood of a telehealth consultation, while being from a non-English speaking country was associated with a reduced likelihood (aOR 0.83 95%CI 0.81 - 0.84). CONCLUSIONS: This study provides evidence showing differences in telehealth use associated with birth country. Strategies to ensure continued healthcare access for patients whose native language is not English, such as providing interpreter services for telehealth consultations, would be beneficial. PERSPECTIVES: Understanding cultural and linguistic differences may reduce health disparities in telehealth access in Australia and could present an opportunity to promote healthcare access in diverse communities.

[Emergency training need and effect evaluation analysis of novel coronavirus pneumonia in centers of disease control and prevention].

A questionnaire was used to investigate the emergency training needs of novel coronavirus pneumonia of disease prevention and control institutions in provinces, deputy provincial level regions and cities specifically designated in the state plan, and the effect evaluation of emergency training activities conducted by Chinese Center for Disease Control and Prevention (China CDC). The results showed that 67.4% of 47 disease prevention and control institutions (31/46) believed that the emergency training at the initial stage of the epidemic should be conducted as soon as possible, and the form of network training should be given priority. The training should focus on the urgently needed technologies such as epidemiological investigation, formulation and response of prevention and control strategies, laboratory testing, etc. The teaching materials should highlight pertinence and practicability and be presented in the form of electronic video. The average satisfaction score of the video training conducted by China CDC was (8.81±1.125) and the score of audio-video courseware was (8.97±0.893). The needs analysis and evaluation of novel coronavirus pneumonia prevention and control in disease prevention and control institutions could provide reference for the follow-up training and improve the emergency training management.

Extracorporeal membrane oxygenation (ECMO) in patients with COVID-19: a rapid systematic review of case studies.

OBJECTIVE: COVID-19 can cause severe acute respiratory distress syndrome (ARDS). Extracorporeal membrane oxygenation (ECMO) can support gas exchange in patients failing conventional mechanical ventilation, but its role is still controversial. We performed a rapid systematic review focusing on the use of ECMO in patients with COVID-19. MATERIALS AND METHODS: PubMed/MEDLINE, Google Scholar, Embase, the Cochrane Library, EBSCO and Ovid (updated 30 April 2020) were systematically searched. Case reports/Case series from COVID-19 patients treated with ECMO were included in the study. Three reviewers assessed, selected, and abstracted data from studies. All disparate opinions were resolved through discussion. RESULTS: We included 13 articles for systematic evaluation, including 10 case reports and 3 case series studies, with a total of 72 patients. We search for the following information: First author of articles; Patient's location; age; gender; body mass index (BMI); Comorbidities; Time on ECMO; Mode of ECMO; treatments and clinical outcomes. As of all reporting times, our data show that 38 patients (52.8%) have died definitively, 13 patients (18.0%) were still receiving ECMO treatment, 12 patients (16.7%) were alive, 7 patients (9.7%) were recovery and 2 cases (2.8%) remained hospitalized. CONCLUSIONS: ECMO plays an important role in the stabilization and survival critically ill patients with COVID-19, but the usefulness of ECMO in reducing the mortality of severe ARDS caused by COVID-19 was limited. Therefore, a larger sample size study and a comprehensive analysis of evaluating the medical value of using ECMO on COVID-19 patients are urgently required.