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1.
Rev Epidemiol Sante Publique ; 69(5): 255-264, 2021 Oct.
Article in French | MEDLINE | ID: covidwho-1347807

ABSTRACT

BACKGROUND: The spring 2020 COVID-19 epidemic severely impacted France's healthcare system. The associated lockdown (17 March- 11 May 2020) and the risk of exposure to SARS-CoV-2 led patients to change their use of healthcare. This article presents the development and implementation of a real-time system to monitor i) private doctors' activity in South-eastern France, and ii) changes in prescription of drugs for people with diabetes, mental health disorders and for certain vaccines from Mars 2020 to October 2020. METHODS: Data extracted from the regional healthcare insurance databases for 2019 and 2020 were used to construct indicators of healthcare use. They were calculated on a weekly basis, starting from week 2 2020 and compared for the same period between 2019 and 2020. RESULTS: Private doctors' activity decreased during the spring 2020 lockdown (by 23 % for general practitioners and 46 % for specialists), followed by an almost complete return to normal after it ended until week 41. Over the same period, a huge increase in teleconsultations was observed, accounting for 30 % of private doctors' consultations at the height of the crisis. The start of the lockdown was marked by a peak in drug prescriptions, while vaccinations declined sharply (by 39 % for the measles, mumps and rubella (MMR) vaccine in children under 5 years old, and by 54 % for human papillomavirus vaccine in girls aged 10-14 years old). CONCLUSION: The ongoing COVID-19 epidemic may lead to health consequences other than those directly attributable to the disease itself. Specifically, lockdowns and foregoing healthcare could be very harmful at the individual and population levels. The latter issue is a concern for French public authorities, which have implemented actions aimed at encouraging patients to immediately seek treatment. However, the COVID-19 crisis has also created opportunities, such as the roll-out of teleconsultation and tele-expertise. The indicators described here as part of the monitoring system can help public decision-makers to become more responsive and to implement tailored actions to better meet the general population's healthcare needs.


Subject(s)
COVID-19/epidemiology , Patient Acceptance of Health Care , Drug Prescriptions/statistics & numerical data , France/epidemiology , Humans , Private Practice/trends , Telemedicine/trends , Vaccination/statistics & numerical data
2.
Urol Int ; 105(7-8): 650-656, 2021.
Article in English | MEDLINE | ID: covidwho-1216840

ABSTRACT

BACKGROUND: There are limited data on the use and concern of telemedicine among German urologists, and thus, there are no established guidelines for telemedical diagnosis, treatment, and prevention of urological indications. METHODS: An anonymized survey was conducted among German private practice urologists during the 2019 coronavirus disease (COVID-19) pandemic. The χ2 test, Mann-Whitney U-test, and Kruskal-Wallis test were used for statistical analysis. RESULTS: 257 urologists were included in the final analysis. Thirty-five (14.0%) of urologists had used telemedicine as part of their consultation, and 221 (86.0%) had not used telemedicine. There was no difference between telemedicine adoption rates between rural and urban settings. Telemedicine users were significantly more satisfied with the information they had received regarding telemedicine issues. Users saw the greatest barrier to telemedicine that patients do not take up the offer of telemedicine. Nonusers were most concerned with unclear indications for telemedicine followed by lesser reimbursements during telemedicine than in-person visitations. Users were significantly more likely to use telemedicine beyond the COVID-19 pandemic. Urologists, who wanted to use the service in the future, wanted an active support by the German society of urology and guidelines for telemedicine. Last, users and nonusers preferred telemedicine for non-acute chronic diseases and follow-up visitations. CONCLUSION: Despite the COVID-19 pandemic, telemedicine remains a rarely used service among German private practice urologists. Ultimately, to overcome the current challenges, urologists require an active support for the service through the German Society of Urology and telemedical guidelines.


Subject(s)
COVID-19 , Practice Patterns, Physicians'/trends , Private Practice/trends , Telemedicine/trends , Urologic Diseases/therapy , Urologists/trends , Urology/trends , Adult , Aged , Attitude of Health Personnel , Attitude to Computers , Germany , Health Care Surveys , Health Knowledge, Attitudes, Practice , Humans , Middle Aged , Urologic Diseases/diagnosis
3.
Australas Psychiatry ; 29(2): 194-199, 2021 04.
Article in English | MEDLINE | ID: covidwho-1099852

ABSTRACT

OBJECTIVE: The Australian federal government introduced new COVID-19 psychiatrist Medicare Benefits Schedule (MBS) telehealth items to assist with providing private specialist care. We investigate private psychiatrists' uptake of video and telephone telehealth, as well as total (telehealth and face-to-face) consultations for Quarter 3 (July-September), 2020. We compare these to the same quarter in 2019. METHOD: MBS-item service data were extracted for COVID-19-psychiatrist video and telephone telehealth item numbers and compared with Quarter 3 (July-September), 2019, of face-to-face consultations for the whole of Australia. RESULTS: The number of psychiatry consultations (telehealth and face-to-face) rose during the first wave of the pandemic in Quarter 3, 2020, by 14% compared to Quarter 3, 2019, with telehealth 43% of this total. Face-to-face consultations in Quarter 3, 2020 were only 64% of the comparative number of Quarter 3, 2019 consultations. Most telehealth involved short telephone consultations of ⩽15-30 min. Video consultations comprised 42% of total telehealth provision: these were for new patient assessments and longer consultations. These figures represent increased face-to-face consultation compared to Quarter 2, 2020, with substantial maintenance of telehealth consultations. CONCLUSIONS: Private psychiatrists continued using the new COVID-19 MBS telehealth items for Quarter 3, 2020 to increase the number of patient care contacts in the context of decreased face-to-face consultations compared to 2019, but increased face-to-face consultations compared to Quarter 2, 2020.


Subject(s)
COVID-19/prevention & control , Mental Disorders/therapy , Mental Health Services/trends , Practice Patterns, Physicians'/trends , Private Practice/trends , Psychiatry/trends , Telemedicine/trends , Ambulatory Care/methods , Ambulatory Care/organization & administration , Ambulatory Care/trends , Australia , COVID-19/epidemiology , Facilities and Services Utilization/trends , Health Services Accessibility/organization & administration , Health Services Accessibility/trends , Humans , Mental Health Services/organization & administration , National Health Programs , Pandemics , Practice Patterns, Physicians'/organization & administration , Private Practice/organization & administration , Psychiatry/organization & administration , Telemedicine/methods , Telemedicine/organization & administration , Telephone/trends , Videoconferencing/trends
4.
Australas Psychiatry ; 29(2): 183-188, 2021 04.
Article in English | MEDLINE | ID: covidwho-962349

ABSTRACT

OBJECTIVE: The Australian Commonwealth Government introduced new psychiatrist Medicare-Benefits-Schedule (MBS)-telehealth items in the first wave of the COVID-19 pandemic to assist with previously office-based psychiatric practice. We investigate private psychiatrists' uptake of (1) video- and telephone-telehealth consultations for Quarter-2 (April-June) of 2020 and (2) total telehealth and face-to-face consultations in Quarter-2, 2020 in comparison to Quarter-2, 2019 for Australia. METHODS: MBS item service data were extracted for COVID-19-psychiatrist-video- and telephone-telehealth item numbers and compared with a baseline of the Quarter-2, 2019 (April-June 2019) of face-to-face consultations for the whole of Australia. RESULTS: Combined telehealth and face-to-face psychiatry consultations rose during the first wave of the pandemic in Quarter-2, 2020 by 14% compared to Quarter-2, 2019 and telehealth was approximately half of this total. Face-to-face consultations in 2020 comprised only 56% of the comparative Quarter-2, 2019 consultations. Most telehealth provision was by telephone for short consultations of ⩽15-30 min. Video consultations comprised 38% of the total telehealth provision (for new patient assessments and longer consultations). CONCLUSIONS: There has been a flexible, rapid response to patient demand by private psychiatrists using the new COVID-19-MBS-telehealth items for Quarter-2, 2020, and in the context of decreased face-to-face consultations, ongoing telehealth is essential.


Subject(s)
COVID-19/prevention & control , Facilities and Services Utilization/trends , Mental Health Services/trends , Practice Patterns, Physicians'/trends , Private Practice/trends , Psychiatry/trends , Telemedicine/trends , Australia/epidemiology , COVID-19/epidemiology , Facilities and Services Utilization/organization & administration , Health Services Accessibility/organization & administration , Humans , Mental Health Services/organization & administration , National Health Programs , Pandemics , Practice Patterns, Physicians'/organization & administration , Private Practice/organization & administration , Psychiatry/methods , Psychiatry/organization & administration , Telemedicine/methods , Telemedicine/organization & administration , Telephone , Videoconferencing
5.
Australas Psychiatry ; 28(6): 639-643, 2020 12.
Article in English | MEDLINE | ID: covidwho-814452

ABSTRACT

OBJECTIVE: To analyse the smaller Australian state/territory service impact of the introduction of new COVID-19 psychiatrist video and telephone telehealth Medicare Benefits Schedule (MBS) items. METHOD: MBS item service data were extracted for COVID-19 psychiatrist video and telephone telehealth item numbers corresponding to the pre-existing in-person consultations for the Australian Capital Territory (ACT), Northern Territory (NT), South Australia (SA) and Tasmania. RESULTS: The overall rate of consultations (face-to-face and telehealth) increased during March and April 2020, compared to the monthly face-to-face consultation average, excepting Tasmania. Compared to an annual monthly average of in-person consultations for July 2018-June 2019, total telepsychiatry consultations were higher for April than May. For total video and telephone telehealth consultations combined, video consultations were lower in April and higher in May. As a percentage of combined telehealth and in-person consultations, telehealth was greater for April and lower for May compared to the monthly face-to-face consultation average. CONCLUSIONS: In the smaller states/territories, the private practice workforce rapidly adopted COVID-19 MBS telehealth items, with the majority of psychiatric consultation shifting to telehealth initially, and then returning to face-to-face. With a second wave of COVID-19 in Australia, telehealth is likely to remain a vital part of the national mental health strategy.


Subject(s)
Coronavirus Infections , Mental Health Services , Pandemics , Pneumonia, Viral , Practice Patterns, Physicians' , Private Practice , Remote Consultation/methods , Videoconferencing , Adult , Australia/epidemiology , Betacoronavirus , COVID-19 , Communicable Disease Control/methods , Coronavirus Infections/epidemiology , Coronavirus Infections/psychology , Female , Humans , Insurance Claim Review , Male , Mental Health Services/organization & administration , Mental Health Services/trends , Organizational Innovation , Pneumonia, Viral/epidemiology , Pneumonia, Viral/psychology , Practice Patterns, Physicians'/organization & administration , Practice Patterns, Physicians'/trends , Private Practice/organization & administration , Private Practice/trends , SARS-CoV-2 , Telemedicine/methods
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