文献类型：期刊文献

英文题名：The Impact of COVID-19 on Primary Care General Practice Consultations in a Teaching Hospital in Shanghai, China

作者：Xu, Zhongqing[1,2,3];Fan, Jingchun[4,5];Ding, Jingjing[1];Feng, Xianzhen[1];Tao, Shunyu[6];Zhou, Jun[1];Qian, Lingmei[1,3];Tao, Kun[1];Hambly, Brett D.[1,7];Bao, Shisan[1,7]

第一作者：Xu, Zhongqing

通信作者：Tao, K[1];Bao, SS[1];Bao, SS[2]

机构：[1]Tongren Hosp, Dept Gen Practice, Shanghai, Peoples R China;[2]Shanghai Jiao Tong Univ, Sch Med, Discipline Gen Practice, Shanghai, Peoples R China;[3]Shanghai Jiao Tong Univ, China Hosp Dev Inst, Ctr Community Hlth Care, Shanghai, Peoples R China;[4]Gansu Univ Chinese Med, Sch Publ Hlth, Lanzhou, Peoples R China;[5]Gansu Univ Chinese Med, Ctr Evidence Based Med, Lanzhou, Peoples R China;[6]Chongqing Med Univ, Sch Publ Hlth, Chongqing, Peoples R China;[7]Univ Sydney, Sch Med Sci, Fac Med & Hlth, Discipline Pathol,Charles Perkin Ctr, D17, Darlington, NSW, Australia

第一机构：Tongren Hosp, Dept Gen Practice, Shanghai, Peoples R China

通信机构：[1]corresponding author), Tongren Hosp, Dept Gen Practice, Shanghai, Peoples R China;[2]corresponding author), Univ Sydney, Sch Med Sci, Fac Med & Hlth, Discipline Pathol,Charles Perkin Ctr, D17, Darlington, NSW, Australia.

年份：2021

卷号：8

外文期刊名：FRONTIERS IN MEDICINE

收录：;Scopus(收录号：2-s2.0-85103873167);WOS:【SCI-EXPANDED(收录号:WOS:000638172200001)】；

基金：This work was supported by grants from Commission of Health, Changning District, Shanghai (YXMZK009, YZJH005, and YJZH003), China Hospital Development Institute, Shanghai Jiao Tong University (CHDI-2020-A-26), Industry Support Plan Project for Colleges and Universities in Gansu Province (2020C-D20), and SJTU research project grant, the University of Sydney.

语种：英文

外文关键词：COVID-19; GP; primary care; lockdown; demographic pattern; psychological disorders

摘要：Background: The COVID-19 (2019 novel coronavirus disease) pandemic is deeply concerning because of its massive mortality and morbidity, creating adverse perceptions among patients likely to impact on their overall medical care. Thus, we evaluated the impact of the COVID-19 pandemic on the pattern of primary care consultations within a Shanghai health district. Methods: A retrospective observational cohort study was performed, with data analyzed concerning the pattern of patient visits to general practitioners within the Tongren Hospital network (the sole provider of general practice to the population of 700,000). Data from all general practice consultations for adults were collected for the first 6 months of 2020, which included a 60-day lockdown period (January 24-March 24, 2020) and compared to corresponding data from the first 6 months of 2019. We evaluated changes to the numbers and patterns of primary care consultations, including subgroup analysis based on age, sex, and primary diagnosis. Results: A substantial reduction in patient visits, associated with increased median age, was observed during the first wave of the pandemic in the first 6 months of 2020, compared to the same interval during 2019. Additionally, reduced reappointments and waiting times, but increased costs per visit were observed. When analyzed by primary disease diagnosis, patient visits were reduced for all the major systems. The most striking visit reductions were in cardiovascular, respiratory, endocrine, and gastrointestinal diseases. However, psychological disorders were increased following lockdown, but there was also a dramatic fall in consultations for depression. Reduced monthly patient numbers correlated with both rate of reappointment and average waiting time during the first 6 months of both 2019 and 2020, but an inverse correlation was observed between cost per visit and monthly patient numbers. Specifically during the lockdown period, there was similar to 50% reduced patient visits. Conclusions: The lockdown has had a serious impact on patients' physical and psychological health. Our analysis provides objective health-related data that may inform the current controversy concerning the balance between the detrimental effects of the use of lockdown vs. the use of a more targeted approach to eliminate viral transmission. These data may improve decision-making in medical practice, policy, and education.