Reorganisation of primary care for older adults during COVID-19: a cross-sectional database study in the UK.
Br J Gen Pract
; 70(697): e540-e547, 2020 08.
Article
in English
| MEDLINE | ID: covidwho-653992
ABSTRACT
BACKGROUND:
The coronavirus disease 2019 (COVID-19) pandemic has resulted in a rapid change in workload across healthcare systems. Factors related to this adaptation in UK primary care have not yet been examined.AIM:
To assess the responsiveness and prioritisation of primary care consultation type for older adults during the COVID-19 pandemic. DESIGN ANDSETTING:
A cross-sectional database study examining consultations between 17 February and 10 May 2020 for patients aged ≥65 years, drawn from primary care practices within the Oxford Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) sentinel network, UK.METHOD:
The authors reported the proportion of consultation type across five categories clinical administration, electronic/video, face-to-face, telephone, and home visits. Temporal trends in telephone and face-to-face consultations were analysed by polypharmacy, frailty status, and socioeconomic group using incidence rate ratios (IRR).RESULTS:
Across 3 851 304 consultations, the population median age was 75 years (interquartile range [IQR] 70-82); and 46% (n = 82 926) of the cohort (N = 180 420) were male. The rate of telephone and electronic/video consultations more than doubled across the study period (106.0% and 102.8%, respectively). Face-to-face consultations fell by 64.6% and home visits by 62.6%. This predominantly occurred across week 11 (week commencing 9 March 2020), coinciding with national policy change. Polypharmacy and frailty were associated with a relative increase in consultations. The greatest relative increase was among people taking ≥10 medications compared with those taking none (face-to-face IRR 9.90, 95% CI = 9.55 to 10.26; telephone IRR 17.64, 95% CI = 16.89 to 18.41).CONCLUSION:
Primary care has undergone an unprecedented in-pandemic reorganisation while retaining focus on patients with increased complexity.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Primary Health Care
/
Coronavirus Infections
/
Betacoronavirus
/
House Calls
Type of study:
Cohort study
/
Observational study
/
Prognostic study
/
Qualitative research
/
Randomized controlled trials
Limits:
Aged
/
Female
/
Humans
/
Male
Country/Region as subject:
Europa
Language:
English
Journal:
Br J Gen Pract
Year:
2020
Document Type:
Article
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