scholarly journals Paediatric primary care in Germany during the early COVID-19 pandemic: the calm before the storm

2021 ◽  
Vol 9 (2) ◽  
pp. e000919
Author(s):  
Malte Kohns Vasconcelos ◽  
Katharina Weil ◽  
Daniela Vesterling-Hörner ◽  
Mehrsad Klemm ◽  
Tarik el Scheich ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Care ◽  
Patient Management ◽  
Healthcare Provision ◽  
Patient Groups ◽  
Paediatric Primary Care ◽  
Care Practices ◽  
Explanatory Sequential Design ◽  
Guidance Needs ◽  
Primary Care Practices

ObjectivesGlobally, the COVID-19 pandemic has a major impact on healthcare provision. The effects in primary care are understudied. This study aimed to explore changes in consultation numbers and patient management during the COVID-19 pandemic, and to identify challenges for patient care.DesignSurvey of paediatric primary care practices on consultation numbers and patient management changes, and semistructured interviews to identify challenges for patient care. Surveys and interviews were partially linked in an explanatory sequential design to identify patient groups perceived to be at higher risk for worse care during the pandemic.SettingIn and around Düsseldorf, a densely populated area in Western Germany. The primary care facilities are spread over an area with approximately 2 million inhabitants.ParticipantsPrimary care in Germany is provided through practices run by self-employed specialist physicians that are contracted to offer services to patients under public health insurance which is compulsory to the majority of the population. The sample contained 44 paediatric primary care practices in the area, the response rate was 50%.ResultsNumbers of consultations for scheduled developmental examinations remained unchanged compared with the previous year while emergency visits were strongly reduced (mean 87.3 less/week in March–May 2020 compared with 2019, median reduction 55.0%). Children dependent on developmental therapy and with chronic health conditions were identified as patient groups receiving deteriorated care. High patient numbers, including of mildly symptomatic children presenting for health certificates, in combination with increased organisational demands and expected staff outages are priority concerns for the winter.ConclusionsPrimary care paediatricians offered stable service through the early pandemic but expected strained resources for the upcoming winter. Unambiguous guidance on which children should present to primary care and who should be tested would help to allocate resources appropriately, and this guidance needs to consider age group specific issues including high prevalence of respiratory symptoms, dependency on carers and high contact rates.

scholarly journals Primary care during the COVID-19 pandemic – observations and challenges identified through a survey and interviews with community paediatricians: the calm before the storm

2021 ◽  
Author(s):  
Malte Kohns Vasconcelos ◽  
Katharina Weil ◽  
Daniela Vesterling-Hörner ◽  
Mehrsad Klemm ◽  
Tarik el Scheich ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Care ◽  
Patient Management ◽  
Structured Interviews ◽  
Healthcare Provision ◽  
Contact Rates ◽  
Developmental Therapy ◽  
Guidance Needs ◽  
Primary Care Practices ◽  
Management Changes

AbstractBackgroundGlobally, the COVID-19 pandemic has a major impact on healthcare provision. The effects in primary care are understudied.AimTo document changes in consultation numbers and patient management during the COVID-19 pandemic, and to identify challenges for patient care.MethodsSurvey of 44 paediatric primary care practices on consultation numbers and patient management changes (response rate 50%), and semi-structured interviews to identify challenges for patient care.ResultsNumbers of consultations for scheduled developmental examinations remained unchanged compared to the previous year while emergency visits were strongly reduced (mean 87.3 less/week in March–May 2020 compared to 2019, median reduction 55.0%). Children dependent on developmental therapy and with chronic health conditions were identified as patient groups receiving deteriorated care. High patient numbers, including of mildly symptomatic children presenting for health certificates, in combination with increased organisational demands and expected staff outages are priority concerns for the winter.ConclusionPrimary care paediatricians offered stable service through the early pandemic but expect strained resources for the upcoming winter. Unambiguous guidance on which children should present to primary care and who should be tested would help to allocate resources appropriately, and this guidance needs to consider age group specific issues including high prevalence of respiratory symptoms, dependency on carers and high contact rates.

Development of a core set of quality indicators for paediatric primary care practices in Europe, COSI-PPC-EU

2018 ◽  
Vol 177 (6) ◽  
pp. 921-933 ◽  
Author(s):  
Dominik A. Ewald ◽  
Gottfried Huss ◽  
Silke Auras ◽  
Juan Ruiz-Canela Caceres ◽  
Adamos Hadjipanayis ◽  
...  
Keyword(s):  
Primary Care ◽  
Quality Indicators ◽  
Core Set ◽  
Paediatric Primary Care ◽  
Care Practices ◽  
Primary Care Practices

scholarly journals Clinical effectiveness and cost effectiveness of individual mental health workers colocated within primary care practices: a systematic literature review

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e042052
Author(s):  
Jean-Baptiste Woods ◽  
Geva Greenfield ◽  
Azeem Majeed ◽  
Benedict Hayhoe
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Cost Effectiveness ◽  
Health Worker ◽  
Health Workers ◽  
Risk Of Bias ◽  
Mental Health Workers ◽  
Mental Health Worker ◽  
Care Practices ◽  
Primary Care Practices

ObjectivesMental health disorders contribute significantly to the global burden of disease and lead to extensive strain on health systems. The integration of mental health workers into primary care has been proposed as one possible solution, but evidence of clinical and cost effectiveness of this approach is unclear. We reviewed the clinical and cost effectiveness of mental health workers colocated within primary care practices.DesignSystematic literature review.Data sourcesWe searched the Medline, Embase, PsycINFO, Healthcare Management Information Consortium (HMIC) and Global Health databases.Eligibility criteriaAll quantitative studies published before July 2019 were eligible for the review; participants of any age and gender were included. Studies did not need to report a certain outcome measure or comparator in order to be eligible.Data extraction and synthesisData were extracted using a standardised table; however, pooled analysis proved unfeasible. Studies were assessed for risk of bias using the Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) tool and the Cochrane collaboration’s tool for assessing risk of bias in randomised trials.ResultsFifteen studies from four countries were included. Mental health worker integration was associated with mental health benefits to varied populations, including minority groups and those with comorbid chronic diseases. Furthermore, the interventions were correlated with high patient satisfaction and increases in specialist mental health referrals among minority populations. However, there was insufficient evidence to suggest clinical outcomes were significantly different from usual general practitioner care.ConclusionsWhile there appear to be some benefits associated with mental health worker integration in primary care practices, we found insufficient evidence to conclude that an onsite primary care mental health worker is significantly more clinically or cost effective when compared with usual general practitioner care. There should therefore be an increased emphasis on generating new evidence from clinical trials to better understand the benefits and effectiveness of mental health workers colocated within primary care practices.

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